J Reconstr Microsurg 2014; 30(08): 539-546
DOI: 10.1055/s-0033-1361839
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pre-expanded Thoracodorsal Artery Perforator-Based Flaps for Repair of Severe Scarring in Cervicofacial Regions

Ai-wu Wang
1   Department of Burn and Plastic Surgery, Center Hospital of Hanzhong City, Hanzhong, China
,
Wan-feng Zhang
1   Department of Burn and Plastic Surgery, Center Hospital of Hanzhong City, Hanzhong, China
,
Feng Liang
1   Department of Burn and Plastic Surgery, Center Hospital of Hanzhong City, Hanzhong, China
,
Jin-you Li
1   Department of Burn and Plastic Surgery, Center Hospital of Hanzhong City, Hanzhong, China
,
Xiao-feng Zhang
1   Department of Burn and Plastic Surgery, Center Hospital of Hanzhong City, Hanzhong, China
,
Xue-tao Niu
1   Department of Burn and Plastic Surgery, Center Hospital of Hanzhong City, Hanzhong, China
› Author Affiliations
Further Information

Publication History

07 May 2013

14 September 2013

Publication Date:
28 March 2014 (online)

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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.

Ethical Approval

Not required.