To investigate the changing trends of neck edema in patients with isolated facial and neck burns or extensive burns combined with inhalation injury， reduce the risk of unplanned extubation and the incidence of iatrogenic pressure injuries in the neck among tracheostomy patients.

A total of 63 burn patients admitted to the Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital， Capital Medical University from June 2023 to December 2024 were enrolled， including 8 patients with isolated facial and neck burns and 55 patients with extensive burns combined with inhalation injury. The patients with extensive burns combined with inhalation injury were stratified into four subgroups based on total burn surface area (TBSA)： 20%–29% TBSA （n=13）， 30%–49% TBSA （n=12）， 50%–69% TBSA （n=14）， and ≥70% TBSA （n=16）. Standardized neck circumference measurements were used to dynamically record the severity of neck edema in each group， and the correlation between the severity of neck edema， the duration of intubation and total burn area was analyzed. Observed the occurrence of tracheal cannula dislocation or pressure injuries related to the fixation belt.

The peak time of neck edema was 24–40 hours post-injury in isolated facial and neck burns group，24–48 hours post-injury in 20%–29% TBSA group， 24–48 hours post-injury in 30%–49% TBSA group， 24–48 hours post-injury in 50%–69% TBSA group， and 16–60 hours post-injury in ≥70% TBSA group. The differences in peak edema time among the groups were statistically significant （P<0.05）. The severity of neck edema and the duration of intubation were positively correlated with total burn area （P<0.05）. During the observation period， there were no cases of tracheal cannula dislocation or pressure injuries related to the fixation belt.

In clinical management， according to the changing pattern of cervical edema after injury in burn patients， dynamic monitoring should be strengthened at key time points， and the tightness of the tracheal tube fixation belt should be adjusted in a timely manner to prevent pressure injuries and unplanned extubation.