Baoqiang Song1, Bo Xiao2, Chaohua Liu2, Lin He2, Yang Li2, Feng Sun2, Kia M Washington3, Yalan Hu4, Dongyue Hao2, Juan Zhang2, Shuzhong Guo5. 1. Department of Plastic Surgery, Xijing Hospital, University of The Fourth Military Medical University, Xi'an, China. Electronic address: songbq2012@163.com. 2. Department of Plastic Surgery, Xijing Hospital, University of The Fourth Military Medical University, Xi'an, China. 3. Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, USA. 4. Department of Plastic Surgery, 260th Hospital of PLA, Shijiazhuang, China. 5. Department of Plastic Surgery, Xijing Hospital, University of The Fourth Military Medical University, Xi'an, China. Electronic address: shuzhong2009@yahoo.com.cn.
Abstract
BACKGROUND: The reconstruction of neck contracture deformities after severe burns is challenging. This is due to insufficient tissue to resurface the large defect after local flap transfer as well as the poor functional and cosmetic results after traditional methods such as skin grafting. We employed free transfer of pre-expanded scapular flaps to reconstruct postburn neck deformities. METHODS: In the first stage, skin expansion was performed with tissue expanders ranging from 400 to 800 mL according to the neck defect size and expanders were filled to their end volumes. In the second stage, the contracture in the neck was released and the unstable scar was resected. The pre-expanded scapular flap was then harvested and transferred to the neck defect. Flap revisions were performed 3-12 months after flap transfer. RESULTS: A total of 12 flaps (100%) were successful. The contour, colour, and texture of flaps matched well to the nearby skin. The range of motion of the neck was significantly improved. The donor defects were closed directly except for one case, which required skin grafting. CONCLUSIONS: The free tissue transfer of pre-expanded scapular flap is a valuable tool in neck burn reconstruction. It can be used safely and effectively with minimal morbidity in selected patients.
BACKGROUND: The reconstruction of neck contracture deformities after severe burns is challenging. This is due to insufficient tissue to resurface the large defect after local flap transfer as well as the poor functional and cosmetic results after traditional methods such as skin grafting. We employed free transfer of pre-expanded scapular flaps to reconstruct postburn neck deformities. METHODS: In the first stage, skin expansion was performed with tissue expanders ranging from 400 to 800 mL according to the neck defect size and expanders were filled to their end volumes. In the second stage, the contracture in the neck was released and the unstable scar was resected. The pre-expanded scapular flap was then harvested and transferred to the neck defect. Flap revisions were performed 3-12 months after flap transfer. RESULTS: A total of 12 flaps (100%) were successful. The contour, colour, and texture of flaps matched well to the nearby skin. The range of motion of the neck was significantly improved. The donor defects were closed directly except for one case, which required skin grafting. CONCLUSIONS: The free tissue transfer of pre-expanded scapular flap is a valuable tool in neck burn reconstruction. It can be used safely and effectively with minimal morbidity in selected patients.