Abstract
Background Reconstruction of cervicofacial scarring continues to present challenges for surgical
treatment. Here we present our clinical experience in repairing cervicofacial scarring
using pre-expanded thoracodorsal artery perforator flaps.
Methods From January 2007 to December 2012, 15 patients were treated for severe cervicofacial
scarring. In the first surgical stage, expanders were implanted subcutaneously in
the zone nourished by thoracodorsal artery perforators. The expansion generally took
3 to 6 months. In the second surgical stage, the cervicofacial cicatricial contracture
was released and the secondary defect was covered with local flaps. The remaining
wound was covered by the free thoracodorsal artery perforator expanded flap, which
was anastomosed to the facial vascular bundle. The donor site was closed directly
in all the patients.
Results The postoperative follow-up time ranged from 1 to 5 years. The deformities were corrected,
all flaps survived completely and none were bulky. The maximum length of the flaps
was 32 cm (mean, 22.4 ± 4.2 cm), and the maximum width was 17 cm (mean, 14.4 ± 2.2
cm). All patients exhibited recovery of neck movement, and there was no recurrence
of neck contracture.
Conclusion The pre-expanded thoracodorsal artery perforator flap is an ideal method for reconstruction
of severe cervicofacial cicatricial contracture.
Keywords
expanded flap - thoracodorsal artery perforator flap - cervicofacial cicatricial contracture
