Postburn head and neck reconstruction in children with the fasciocutaneous supraclavicular artery island flap.

Postburn deformities or scar contractures in the head and neck region of children represent a challenge with unique problems compared with the rest of the body. Fourteen children suffered from neck contractures following burns, and 4 children required reconstruction following panfacial burn deformities. The experience of late-phase secondary burn reconstruction in the head and neck region of 18 pediatric patients (age range, 9-17 years) with 22 fasciocutaneous supraclavicular island flaps, including 5 preexpanded flaps, is reported. Clinical follow-up was performed between 10 and 29 months postoperatively. High functional and esthetic requirements could be fulfilled in all patients. Flap complications occurred in 9%, with low donor site morbidity (9%). The fasciocutaneous supraclavicular artery island flap is reliable and safe for immediate or late resurfacing of facial defects and to release cervical contractures. Customized flap design with tissue expansion without the need for microsurgery allows extended indications and optimized skin utilization, while good texture and color match is generally difficult to achieve in the head and neck region of severely burned children.