[Facial and cervical reconstractions using expanded flap from medial upper arm].

OBJECTIVE

To investigate the blood supply of the expanded skin flap from the medial upper arm and its application for the repair of facial and cervical scar.

METHODS

From May 2000 to February 2007, 20 cases (12 males and 8 females; aging from 7 to 42 years) of facial and cervical scar were treated with the expender flap from medial upper arm. The disease course was 9 months to 20 years. The size of the scar was 8 cm x 6 cm-22 cm x 18 cm. The operation was carried out for three steps: (1) The expander was embed under the superior proper fascia. (2) The scar in the face and cervix was loosed and dissected. Combined the expanded skin flap from the medial upper arm (the size of the flap was 9 cm x 7 cm-24 cm x 18 cm) in which the blood supply to the flap was the superior collateral artery and the attributive branches of the basilica with auxiliary veins for blood collection with partial scar flap (3.5 cm x 2.5 cm-8.0 cm x 6.0 cm) was harvested and transferred onto the facial and cervical defect. (3) After being cut off the pedicle, the scar was dissected. The expanded flap was employed to cover the defect.

RESULTS

After 3-24 months follow-up with 16 cases, all the grafted skin flaps survived at least with nearly normal skin color, texture and contour. The scars at the donor sites were acceptable. The function and appearance of the face and cervix was improved significantly. No surgery-related significant complications were observed.

CONCLUSION

Repair of facial and cervical scar with the medial upper arm expanded skin flap is a plausible reconstructive option for head and face reconstructions. However, a longer surgery time and some restrictive motion of the harvested upper limbs might be a disadvantage.