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Scar contracture after neck dissection. Causes, prevention, and treatment.

Every effort should be made to employ neck incisions that allow for the accomplishment of surgical extirpative goals and at the same time provide maximal functional and aesthetic rehabilitation. Incisions parallel to the normal skin tension lines best fulfill these criteria. When vertical incisions are used, they should be anteriorly directed so as to cross the skin crease lines at an acute angle rather than a perpendicular angle. Such incisions perpendicular to the normal skin crease lines usually result in the greatest degree of scar contracture. Significant improvement in both major and minor scar contractures can be achieved with conventional Z-plasty technics to redistribute the skin tension. A wide resection of the subcutaneous cicatrix in such cases is imperative for a successful result.

Cicatrix↗

[Methodological approaches to study characteristics of surgical anatomy of episublingual area and carotid triangle securing neck dissection within fascial sheaths].

The studies performed in 91 non-fixed human cadavers included: layer-by-layer preparation of the tissues to the depth of the bottom of operation wound after cervical lymphadenectomy within the whole anterior triangle of the neck; layer-by-layer preparation within the limits of anatomical zones and structures of the anterior triangle of the neck; study of the number and completeness of fascial sheaths in the same locations using the developed method. The anatomical findings obtained necessitate re-consideration of the conventionally described submandibular triangle medial and lateral borders in favor of their expansion. The study has defined the fascial plate dividing the contents of submandibular and carotid triangles and has specified the lines of tissue dissection with the purpose to improve the ablasticity of neck dissection operations for metastases of maxillofacial malignant tumors.

Cadaver↗

Neck dissection.

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Humans↗