## 2 Material and Methods
Eight months later, the patient presented to our clinic with contractures, keloids, and hypertrophic scars affecting the burned areas as well as the grafted parts, in spite of pressure garments and physiotherapy. First we considered the contracted scars from the limbs--we performed several interventions in order to \begin{table}
\begin{tabular}{c c c c c c c c} \hline \hline \multirow{2}{*}{**Case No.**} & **Age** & **Size** & **Time Accident-** & **Generation** & **Other** & **Defect Size** & **Complications** & **Follow-up** \\  & **(Years)** & **Sex** & **Integra (Years)** & **Sex Location** & **Reconstructive** & **Procedures** & **(mm)** & **Stratharma AG, Basel, Switzerland) or any greasy ointment applied twice a day) for 6-9 months. Postoperative follow-up was 12-24 months. & \\ \hline \multirow{2}{*}{1.} & \multirow{2}{*}{26} & \multirow{2}{*}{F} & \multirow{2}{*}{2} & Whole anterior and & & & \\  & & & lateral cervical & & & & \\  & & & and inferior & & & & \\  & & & & mandibular areas & & & \\ \hline \multirow{2}{*}{2.} & \multirow{2}{*}{43} & \multirow{2}{*}{F} & \multirow{2}{*}{1} & Anterior and & & & \\  & & & & Interacerervical areas & No & 120/110 &
\begin{tabular}{c} Infection with \\ _Staphylococcus_ \\ _aureus_ \\ \end{tabular} & 12 \\ \hline \multirow{2}{*}{3.} & \multirow{2}{*}{21} & \multirow{2}{*}{F} & \multirow{2}{*}{10} & Anterior cervical and & & & \\  & & & inferior mandibular & Yes & 150/115 & None & 16 \\ \hline \multirow{2}{*}{4.} & \multirow{2}{*}{50} & \multirow{2}{*}{F} & \multirow{2}{*}{11} & Anterior cervical, & & & \\  & & & & inferior mandibular and & & \\  & & & anterior thoracic areas & & & \\ \hline \multirow{2}{*}{5.} & \multirow{2}{*}{32} & \multirow{2}{*}{M} & \multirow{2}{*}{1 + 2 months} & Left lateralorecervical area & No & 160/150 & None & 14 \\ \hline \multirow{2}{*}{6.} & \multirow{2}{*}{28} & \multirow{2}{*}{M} & \multirow{2}{*}{2} & Anterior cervical, & & & \\  & & & inferior mandibular and & & & \\  & & & superior anterior & & & \\  & & & thoracic areas & & & \\ \hline \multirow{2}{*}{7.} & \multirow{2}{*}{34} & \multirow{2}{*}{F} & \multirow{2}{*}{3} & Left lateralorecervical area & Yes & 140/120 & None & 18 \\ \hline \multirow{2}{*}{8.} & \multirow{2}{*}{26} & \multirow{2}{*}{F} & \multirow{2}{*}{1 + 7 months} & Anterior cervical, & & & \\  & & & inferior mandibular and & & & \\  & & & left grain areas & & & \\ \hline \multirow{2}{*}{9.} & \multirow{2}{*}{43} & \multirow{2}{*}{F} & \multirow{2}{*}{1 + 8 months} & Whole anterolateral area & No & 140/115 & None & 18 \\ \hline \multirow{2}{*}{10.} & \multirow{2}{*}{39} & \multirow{2}{*}{F} & \multirow{2}{*}{2} & Anterior cervical, & & & \\  & & & inferior chin and & & & \\  & & & anterior thoracic areas & & & \\ \hline \multirow{2}{*}{11.} & \multirow{2}{*}{36} & \multirow{2}{*}{F} & \multirow{2}{*}{1 + 8 months} & Right lateralorecervical, & & & \\  & & & mandibular and right & & & \\  & & & & automatic areas & & \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Using Integra for the reconstruction of neck regions of eleven cases followed up. release the scars (from Z-plasty, local flaps and tissue expansion). The main problem was the face and the neck; the evolution of the scars was unsatisfactory. Two years after the burn trauma the neck scar made us consider Integra as an ideal treatment. (Figure 1A) The neck flexion contracture and hypertrophic scars were excised completely, and we applied Integra non-meshed and tailored to fit the wound, and nine days after surgery we saw the first signs of new neoformans formation (Integra becomes yellow with little red spots). (Figure 1B,C). Three weeks later we performed the second stage of the procedure. (Figure 1D). The patient was discharged seven days after surgery in good condition with the grafts completely integrated. Nine months after, the grafted area was soft, supple, pliable and elastic, without contracture and keloid formation, more alike to normal skin, the mobility of the head and neck was normal, and the patient was very satisfied with the result. (Figure 1E).