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.
From the 2nd Department of Plastic Surgery, Plastic Surgery Hospital of Peking Union Medical College and The Chinese Academy of Medical Science, Beijing, China.
Received March 25, 2014, and accepted for publication, after revision, April 1, 2014.
Conflicts of interest and sources of funding: none declared
Reprints: Yangqun Li, MD, The 2nd Department of Plastic Surgery, Plastic Surgery Hospital of Peking Union Medical College and The Chinese Academy of Medical Science. No. 33 Ba-da-chu Road, Shijingshan District, Beijing 100144, China. E-mail: email@example.com.
This work was presented in part at the 3rd World Congress for Plastic Surgeons of Chinese Descent (WAPSCD) Oct 12–14, 2012, in Xi’an, China.
The manuscript has been selected to be published in a special WAPSCD issue for Annals of Plastic Surgery and the manuscript has been peer-reviewed by the publication committee of WAPSCD.