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Page 2 of 6 Gupta et al. Plast Aesthet Res 2018;5:46 I http://dx.doi.org/10.20517/2347-9264.2018.66

Figure 1. The modified neck splint

Figure 2. Materials required

METHOD AND MATERIALS
We present a case of a 23-year-old female presented to casualty with history of accidental flame thermal burn
involving face, neck, chest and upper limbs constituting 25% of total body surface area with inhalational
injury. Patient had stridor suggesting airway compromise, on attempted endotracheal intubation, severe
upper airway edema was noted with non visualization of vocal chords so the patient was tracheostomized
and was resuscitated as per Parkland formula. Hard cervical collar commonly applied to immobilize neck
couldn’t be fitted with tracheostomy tube in situ. To overcome this problem modification of hard cervical
collar was designed [Figure 1].

We used medium size hard cervical collar (cost: INR300; USD5; Dynamic Techno Medicals Pvt. Ltd.)
made up of poly vinyl chloride (PVC) [Figure 2]. The lower part of cervical collar was cut with stout
scissors in a shape of inverted “U” in its central part. While cutting the collar all the sharp projections were
removed to make margins rounded. A clean piece of foam was cut into the half doughnut shape and fixed
on the margins with the help of micropore tape [Figure 3]. After this modification collar was fit into the
neck, providing pressure and positioning to the neck and simultaneously allowing rotational mobility for
physiotherapy. Base of modified collar was stable from lateral sides [Figure 4]. Design map for modified neck
splint is shown in Figure 5.

Modified cervical splint served the purpose of providing immobilization and alleviating pain during acute
phase. Patient was well compliant to continuous application of modified cervical splint. Nursing caregivers