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Annals of Plastic Surgery:
doi: 10.1097/SAP.0000000000000245
Clinical Articles

Pre-Expanded Cervico-Acromial Fasciocutaneous Flap Based on the Supraclavicular Artery for Resurfacing Post-Burn Neck Scar Contractures

Yang, Zhe MD; Hu, Chunmei MD; Li, Yangqun MD; Tang, Yong MD; Zhao, Muxin MD; Chen, Wen MD; Xu, Lisi MD; Liu, Yuanyuan MD

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Abstract

Objective: Post-burn cicatricle contractures of neck pose a challenge for plastic and reconstructive surgeons. To improve functional and cosmetic results, and to minimize the donor-site morbidity, we use pre-expanded cervico-acromial fasciocutaneous flap based on the supraclavicular artery as a feasible choice for resurfacing large skin defects of the neck.

Methods: In this series, from 2008 to 2012, 18 patients with ages ranging between 11 and 42 years (20 flaps with 2 patients in bilateral fashion) suffering from post-burn scar contractures of the neck were treated. In the first stage, an expander was implanted on the deep fascia layer of the cervico-acromial region; 600 to 800 mL of saline was then injected during a 10- to 16-week period. In the second stage after expansion, sufficient skin and tissue was obtained to resurface the defects of the neck after releasing the contractures and excision of post-burn scars.

Result: All 20 flaps healed primarily with good functional and cosmetic results. The maximum size was 23 × 16 cm, whereas the minimum was 20 × 8 cm. After an average follow-up time of 12 months, significant improvement in range of motion with good esthetic outcomes were achieved, and the scars in donor sites seemed acceptable. There ware no significant complications.

Conclusions: The pre-expanded cervico-acromial fasciocutaneous flap based on the supraclavicular artery can provide a large amount of thin tissue with both good color and texture, and without the need for microsurgery, and avoid the disadvantages of donor-site morbidity. This flap is reliable and safe for resurfacing large skin defects of the neck.

© 2014 by Lippincott Williams & Wilkins

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