The island pre-expanded supratrochlear artery flap in the treatment of midfacial giant nevus in children
10.3760/cma.j.cn114453-20211025-00416
- VernacularTitle:额部滑车上动脉岛状预扩张皮瓣治疗儿童面中部鼻旁巨痣
- Author:
Weidong WANG
1
;
Weimin SHEN
;
Jie CUI
;
Jianbing CHEN
;
Jiageng XIONG
Author Information
1. 南京医科大学附属儿童医院烧伤整形科，南京 210008
- Keywords:
Surgical flaps;
Supratrochlear artery;
Face;
Child;
Soft tissue expander;
Giant nevus
- From:
Chinese Journal of Plastic Surgery
2022;38(11):1249-1253
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the feasibility and effect of applying the island pre-expanded supratrochlear artery flap to treat mid-facial giant nevus near the nose in children.Methods:From January 2019 to January 2021, 10 cases of midfacial giant nevus patients were treated with the island pre-expanded supratrochlear artery flap in the Department of Burn and Plastic Surgery of Children’s Hospital of Nanjing Medical University. The process of treatment was divided into three stages. Stage 1: The expander capacity was determined according to the lesion size. The expander was implanted under the frontal muscle, and the flap was regularly expanded postoperatively. Stage 2: The expander was removed, and the lesion was excised. The expanded flap was designed according to the shape and size of the lesion. Stage 3: The transferred flap was trimmed. The postoperative complications and the blood supply after flap transfer were observed. The treatment effect was evaluated during the follow-up after the operation.Results:A total of 10 children were included in this group, including six males and four females, aged 4-12 years, with an average age of 7.8 years. Six patients underwent three-stage surgery, and four patients underwent two-stage surgery. During the first stage, a 100-400 ml renal expander was implanted, and tissue expansion was conducted once or twice a week. The expansion lasted 10 to 12 weeks (average, 11.4 weeks). Complications such as leakage, angle, and blood supply obstruction were not observed during the expansion process. The size of the expanded frontal flap was 7 cm × 6 cm ~ 12 cm ×10cm. Venous congestion occurred at the distal end of the flap in 2 cases, which was treated by partial suture removal and acupuncture bleeding treatment. No flap necrosis occurred. The donor sites were closed directly. No recurrence was observed during the 3-month to 1-year follow-up period. All expanded flaps had no obvious contraction with a good match of color and texture.Conclusions:The island pre-expanded supratrochlear artery flap provides an ideal selection of donor site for a large mid-facial defect with a reliable effect. The scar in the middle face and secondary deformities can be avoided.
