Tian Jia, Fan Jincai, Liu Liqiang, Gan Cheng, Yang Zengjie, Chen Wenlin, Yin Zhuming
From the Ninth Department of Plastic Surgery, Plastic Surgery Hospital of Chinese Academy of Medical Sciences, Beijing, China.
Ann Plast Surg. 2016 Feb;77 Suppl 1:S43-8. doi: 10.1097/SAP.0000000000000829.
The cervical area is well acknowledged as an ideal donor site for aesthetic reconstruction of the cheek, and tissue expansion may play an important role for maximally achieving such a purpose. However, the conventional design of the expanded cervical flap generally results in unsightly morbidity of the donor site. The aim of this study is to evaluate the results of using an improvised cervical expanded flap in aesthetic reconstruction of the cheek.
From July 2004 to October 2012, a total of 23 burn sequelae patients (30 cheeks) underwent cheek reconstruction with an expanded flap that originated from the cervicoperiauricular area. The procedures were initially carried out with the insertion of a round tissue expander in the cervicoperiauricular area, followed by serial inflation of the expander, and finally, transplantation of the expanded flap to the cheek in a rotation advancement fashion. The donor site closure was along the auricular sulcus.
The average area of the harvested flaps was 9.7 × 8.1 cm. All the flaps completely survived, only one major complication occur-a dome exposure of the tissue expander after the expansion was completed. The flap was salvaged, and the transfer stage was done without intact. Minor complications after flap transfer include: widened scar at the donor site, a "dog-ear" needing additional minor surgery, distal part of the flap transient congestion. The patients achieved very satisfactory results functionally and aesthetically.
Using the expanded cheek-shaped flap technique can provide a safe, thin, and color-matched flap in aesthetic reconstruction of the cheek with minimal donor site morbidity.
颈部被公认为是用于面颊美学重建的理想供区，组织扩张术对于最大程度实现这一目的可能发挥重要作用。然而，传统设计的扩张颈部皮瓣通常会导致供区出现难看的并发症。本研究的目的是评估使用改良的颈部扩张皮瓣进行面颊美学重建的效果。
2004年7月至2012年10月，共有23例烧伤后遗症患者（30侧面颊）接受了源自颈耳周区域的扩张皮瓣进行的面颊重建。手术最初在颈耳周区域植入一个圆形组织扩张器，随后对扩张器进行系列注水，最后将扩张皮瓣以旋转推进的方式移植到面颊。供区沿耳沟闭合。
切取皮瓣的平均面积为9.7×8.1cm。所有皮瓣均完全存活，仅发生1例主要并发症——扩张完成后组织扩张器穹顶外露。皮瓣得以挽救，转移阶段顺利完成。皮瓣转移后的轻微并发症包括：供区瘢痕增宽、一处“猫耳”需要额外的小手术、皮瓣远端短暂性充血。患者在功能和美学方面均取得了非常满意的效果。
使用扩张的面颊形皮瓣技术可为面颊美学重建提供安全、薄且颜色匹配的皮瓣，同时供区并发症最少。
