Clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns.
10.3760/cma.j.cn501120-20211231-00426
- VernacularTitle:扩张胸背动脉穿支皮瓣游离移植整复烧伤后颈部瘢痕挛缩畸形的临床效果
- Author:
Peng JI
1
;
Tao CAO
1
;
Zhi ZHANG
1
;
Yue ZHANG
1
;
Shi Jun HU
2
;
Jun Chang WANG
3
;
Chao HAN
1
;
Jing WANG
1
;
Ji Hong SHI
1
;
Da Hai HU
1
;
Ke TAO
1
Author Information
1. Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China.
2. Department of Burns and Plastic Surgery, Bozhou City People's Hospital, Bozhou 236814, China.
3. Department of Burns and Plastic Surgery, Shihezi City People's Hospital, Shihezi 832099, China.
- Publication Type:Observational Study
- MeSH:
Arteries;
Burns/surgery*;
Cicatrix/surgery*;
Contracture/surgery*;
Female;
Humans;
Hyperplasia;
Male;
Perforator Flap;
Reconstructive Surgical Procedures;
Skin Transplantation;
Soft Tissue Injuries/surgery*;
Treatment Outcome
- From:
Chinese Journal of Burns
2022;38(4):328-334
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns. Methods: A retrospective observational study was conducted. From May 2018 to April 2021, 11 patients with cervical cicatrix contracture deformity after burns who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University, including 3 males and 8 females, aged 5 to 46 years, with a course of cervical cicatrix contracture deformity of 5 months to 8 years. The degree of cervical cicatrix contracture deformity was degree Ⅰ in one patient, degree Ⅱ in nine patients, and degree Ⅲ in one patient. In the first stage, according to the sizes of neck scars, one rectangular skin and soft tissue expander (hereinafter referred to as expander) with rated capacity of 200 to 600 mL was placed in the back. The expansion time was 4 to 12 months with the total normal saline injection volume being 3.0 to 3.5 times of the rated capacity of expander. In the second stage, free expanded thoracodorsal artery perforator flaps with areas of 10 cm×7 cm to 24 cm×13 cm were cut out to repair the wounds with areas of 9 cm×6 cm to 23 cm×12 cm which was formed after cervical cicatectomy. The main trunk of thoracodorsal artery and vein were selected for end-to-end anastomosis with facial artery and vein, and the donor sites were directly closed. The survival of flaps and healing of flap donor sites were observed on the 14th day post surgery. The appearances and cicatrix contracture deformity of the flaps, recovery of cervical function, and scar hyperplasia of donor sites were followed up. Results: On the 14th day post surgery, the flaps of ten patients survived, while ecchymosis and epidermal necrosis occurred in the center of flap of one patient and healed 2 weeks after dressing change. On the 14th day post surgery, the flap donor sites of 11 patients all healed well. During the follow-up of 6-12 months post surgery, the flaps of ten patients were similar to the skin around the recipient site in texture and color, while the flap of one patient was slightly swollen. All of the 11 patients had good recovery of cervical function and no obvious scar hyperplasia nor contracture in the flaps or at the donor sites. Conclusions: Application of expanded thoracodorsal artery perforator flaps can restore the appearance and function of the neck, and cause little damage to the donor site in reconstructing the cervical cicatrix contracture deformity after burns, which is worthy of clinical reference and application.
