Wang Ai-Wu, Zhang Wan-Feng, Liang Feng, Li Jin-You, Zhang Xiao-Feng, Niu Xue-Tao
Department of Burn and Plastic Surgery, Center Hospital of Hanzhong City, Hanzhong, China.
J Reconstr Microsurg. 2014 Oct;30(8):539-46. doi: 10.1055/s-0033-1361839. Epub 2014 Mar 28.
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.
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.
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.
The pre-expanded thoracodorsal artery perforator flap is an ideal method for reconstruction of severe cervicofacial cicatricial contracture.
头面部瘢痕的修复仍是外科治疗的挑战。在此，我们展示使用预扩张胸背动脉穿支皮瓣修复头面部瘢痕的临床经验。
2007年1月至2012年12月，15例严重头面部瘢痕患者接受治疗。在第一阶段手术中，在胸背动脉穿支供血区域皮下植入扩张器。扩张通常需要3至6个月。在第二阶段手术中，松解头面部瘢痕挛缩，用局部皮瓣覆盖继发缺损。剩余创面用游离的预扩张胸背动脉穿支皮瓣覆盖，并与面血管束吻合。所有患者供区均直接缝合。
术后随访时间为1至5年。畸形得到矫正，所有皮瓣完全存活，无一臃肿。皮瓣最大长度为32 cm（平均22.4±4.2 cm），最大宽度为17 cm（平均14.4±2.2 cm）。所有患者颈部活动均恢复，颈部挛缩无复发。
预扩张胸背动脉穿支皮瓣是修复严重头面部瘢痕挛缩的理想方法。
