Application of sequential flap transfer technique for the reconstruction of extensive faciocervical scar
10.3760/cma.j.cn114453-20221022-00335
- VernacularTitle:应用皮瓣连续转移技术修复大面积面颈部瘢痕
- Author:
Zixiang CHEN
1
;
Yuanbo LIU
;
Miao WANG
;
Shan ZHU
;
Bo CHEN
;
Shanshan LI
;
Tinglu HAN
;
Mengqing ZANG
Author Information
1. 中国医学科学院北京协和医学院整形外科医院瘢痕综合治疗中心，北京 100144
- Keywords:
Surgical flaps;
Faciocervical scar;
Sequential flap transfer;
Medial arm flap;
Supraclavicular artery flap;
Latissimus dorsi myocutaneous flap;
Thoracodorsa
- From:
Chinese Journal of Plastic Surgery
2023;39(5):472-478
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effectiveness of sequential flap transfer technique in the reconstruction of extensive faciocervical scar.Methods:The clinical data of patients with extensive faciocervical scar admitted to the Scar Comprehensive Treatment Center of Plastic Surgery Hospital of Chinese Academy of Medical Sciences from June 2010 to April 2022 were retrospectively analyzed. Pre-expanded medial arm flap or supraclavicular artery perforator plus flap were harvested and used as the first flap to repair the defects left by faciocervical scar resection. Latissimus dorsi myocutaneous flaps or thoracodorsal artery perforator flaps were harvested from the ipsilateral back and used as the second flap to repair the donor sites of the first flap. Donor sites at the back were directly sutured. The survival of flaps, the morphology of donor sites and recipient sites and the scar of donor site were followed up.Results:A total of 13 patients, aged from 5 to 36 years (median age, 14 years), were included, including 8 males and 5 females. Twelve of the 13 cases were post-burn scar, including facial scars in 5 cases, cervical scar in 1 case and faciocervical scar in 6 cases. One case of scar was caused by radiotherapy for facial hemangioma. The size of defects after scar resection and release ranged from 12.0 cm × 8.0 cm to 24.5 cm × 8.0 cm. The operation was successfully completed in all cases. Three pre-expanded supraclavicular artery perforator plus flaps and 10 pre-expanded medial arm flaps, measuring 23.0 cm × 7.0 cm to 27.0 cm ×14.0 cm, were used as the first flap; five latissimus dorsi myocutaneous flaps and eight thoracodorsal artery perforator flaps, measuring 18.0 cm × 7.0 cm to 25.0 cm × 10.0 cm, were used as the second flap. One patient developed hematoma at two days after the pedicle division of medial arm flap and the flap survived completely after removal of the hematoma. Other flaps survived without complications and the incisions were healed in one stage. Patients were followed up for 1 to 48 months, with a median follow-up of 13 months. The color, texture, and thickness of flaps were similar to those of the recipient site. All patients were satisfied with the cosmetic result of recipient sites and donor sites.Conclusion:The sequential flap transfer technique could improve the reconstructive ability of pre-expanded medial arm flap and supraclavicular artery perforator plus flap in surgical treatment of extensive faciocervical scar, minimize the donor site morbidities, assist the closure of donor site and improve the overall outcomes.
