The Clinical Application of Preexpanded and Prefabricated Super-Thin Skin Perforator Flap for Reconstruction of Post-Burn Neck Contracture. (August 2016)

• Record Type: Journal Article
• Authors: Wang, Chunmei; Zhang, Junyi; Yang, Sifen; Hyakusoku, Hiko; Song, Ping; Pu, Lee L.Q.
• Is Part Of: Annals of plastic surgery. Volume 77(2016:Jul.)Supplement 1
• Publication Date: 2016-08
• Subjects: preexpansion -- prefabrication -- crossing-area blood supply -- super-thin flaps -- perforator flaps; Surgery, Plastic -- Periodicals; 617.95205
• DOI: 10.1097/SAP.0000000000000711
• Languages: English
• ISSNs: 0148-7043

Abstract

Abstract : Objective: Based on our previous animal study, we applied the "bridging effect" to the neighboring axial flap through preexpansion and prefabrication of a skin perforator flap as a new method to reconstruct a large skin defect after release of severe neck burn scar contracture. Methods: Twelve patients suffering from severe post-burn cervical contractures underwent reconstruction of large skin defects after surgical release of severe scar contractures with preexpanded and prefabricated super-thin skin perforator flaps supplied primarily by a number of perforators via the "bridging effect" from the branches of the adjacent arteries as 2-stage procedures. During the first-stage operation, 2 tissue expanders were placed accordingly, and this was followed by a subsequent second-stage procedure where an expanded super-thin skin perforator flap was transposed to reconstruct a large neck skin defect. Follow-up was between 6 months and 3 years in this series. Results: All super-thin skin perforator flaps survived in this series with primary healing except one with a distal flap necrosis that was treated with a subsequent skin graft. All patients have had a good contour with improved range of motion in the neck. Conclusions: The preexpansion and prefabrication of a super-thin skin perforator flap can possibly improve the anastomoses between neighboring subdermal vascular plexuses and extend the supplying area of these vessels to the flap. This method may provide a favorable super-thin skin flap that can be used for reconstruction of large neck defects after release of post-burn cervical scar contracture as demonstrated in this case series.