The extra-long artery-pedicled back fascia skin flap for treatment of cervical contractive scar.

Severe cervical scar contractive after burn is best repaired with a flap for the neck maximal function restoration. The trapezius myocutaneous flap is a common one to be used for this purpose. However, the traditional technique is usually not appreciated to transfer the flap to the opposite side of the neck in one stage. The delayed procedures are usually needed. In this paper, an extra-long back fascia flap pedicled with descending branch of transverse cervical artery was developed to restore the whole cervical contractive scar after burn in only one operation. With our experience of 25 patients, the flap was usually formed as large as 10-14 cm wide (18-20 cm in expanded cases) and 35-45 cm long, as twice long as that formed by the traditional technique, and easily reaching the opposite side of the neck. Finally, the flaps were successfully transferred to repair the full neck in only one-stage procedure after the cervical scars were excised, except for two cases with partial necrosis in the flap tip. But the wounds were closed with further advancing the flap in secondary operation. In the end all of the patients were completely repaired. The result indicates that the extra-long back fascia flap pedicled with descending branch of transverse cervical artery could be formed long enough to reach the opposite side of the neck and safely transferred to neck in one stage.