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CC BY-NC 4.0 · Arch Plast Surg 2020; 47(02): 194-197
DOI: 10.5999/aps.2019.00591
Idea and Innovation

Reconstruction of post-burn anterior neck contractures using a butterfly design free anterolateral thigh perforator flap

Alexandre G. Lellouch 
Department of Plastic Reconstructive Surgery, European Georges Pompidou Hospital (AP-HP), Paris Descartes University, Paris, France
Division of Plastic and Reconstructive Surgery, and Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
,
Zhi Yang Ng 
Division of Plastic and Reconstructive Surgery, and Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
,
Victor Pozzo
Department of Plastic Reconstructive Surgery, European Georges Pompidou Hospital (AP-HP), Paris Descartes University, Paris, France
,
Tabrez Suffee
Department of Plastic Reconstructive Surgery, European Georges Pompidou Hospital (AP-HP), Paris Descartes University, Paris, France
,
Laurent A. Lantieri
Department of Plastic Reconstructive Surgery, European Georges Pompidou Hospital (AP-HP), Paris Descartes University, Paris, France
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Anterior neck burns represent a major reconstructive challenge due to severe sequalae including restriction in movement and poor aesthetic outcomes. Common treatment options include skin grafting with/without dermal matrices, and loco-regional and distant free flap transfers with/without prior tissue expansion. Such variation in technique is largely influenced by the extent of burn injury requiring resurfacing. In order to optimize like-for-like reconstruction of the anterior neck, use of wide, thin and long flaps such as the anterolateral thigh (ALT) perforator flap have been reported with promising results. Of note, some patients have a tendency towards severe scar contractures, which may be contributed by the greater extent of inflammation during wound healing. We report our experience at 4 years’ follow-up after secondary reconstruction of severe, anterior neck burn contractures in two patients by harvesting the ALT flap with a butterfly design. This technique provides adequate wound resurfacing of the burned neck and surrounding areas, and provides good neck extensibility by addressing both anterior and lateral aspects of the scar defect simultaneously. Such a flap design reduces tension on wound edges and thus, the risk of contracture recurrence in what remains a particularly challenging type of burn reconstruction.

Keywords

Free flap - Neck - Reconstructive surgical procedures - Burns - Contracture

This article was presented at the 50th Annual Meeting of the American Burn Association on April 10-13, 2018, in Chicago, IL, USA.




Publication History

Received: 22 April 2019

Accepted: 23 November 2019

Article published online:
22 May 2022

© 2020. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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