Burn injury in children: declining need for reconstructive surgery as related to use of neck orthoses.

A 9-year study of the results of treatment of 143 acute and reconstructive cases involving thermal injury to the neck compares 2 periods of treatment, 1964-1968 and 1968-1971. Number of grafts as well as Z-plasties is documented. A decline in the number of operative procedures required per patient is demonstrated in the later period; for acute cases a mean of 3.2 dropped to 1.1, and for reconstructive cases from 2.4 to 1.1. The declining necessity for reconstructive procedures is related to the increasing use of transparent molded polyvinylchloride neck orthoses. In reconstructive cases improved postoperative positioning with a special cervical hypertension mattress has been useful.