Hu Xiaogen, Zeng Gao, Zhou Yang, Sun Cheng
Plastic Surgery Department, China Japan Friendship Hospital, Beijing, China.
J Craniofac Surg. 2017 Mar;28(2):e137-e141. doi: 10.1097/SCS.0000000000003394.
The reconstruction of major burn and other deformities resulting from significant soft tissue deficits of the face is a continuing challenge for surgeons. In the study, the authors introduce our 5-year experiences using expanded flap in the neck for reconstruction on the mid and lower face.
From 2008 and 2013, 12 tissue expanders were used in 12 patients for face resurfacing. The operation consisted of 2 steps. In the first step, the expander was placed subcutaneously under the skin of the neck and they were expanded timely to create adequate superfluous skin and soft tissue. In the second step, the expanded flap was transferred to reconstruct the defects on the mid and lower face after excision of the lesions.
All 12 patients with lesions on the mid and lower face underwent successful facial resurfacing with the described technique in the last 5 years. The follow-up ranged from 6 to 24 months. Flaps did not shrink after the operations, and subsequent contractures did not recur. The cervicomental angle appeared normal. All flaps survived well except 2 patients developed slight necrosis at the distal edge and no other major complication was observed. Esthetic outcomes were rated to be very good in 10 patients (83.3%) and good in 2 patients (16.7%).
The application of expanded flaps in the neck is proved to be an effective way of repairing facial defects on the mid and lower face. The technique is remarkably reliable in resurfacing the peripheral facial esthetic units.
面部严重软组织缺损导致的大面积烧伤及其他畸形的重建，一直是外科医生面临的挑战。在本研究中，作者介绍了我们5年来使用颈部扩张皮瓣修复面中下部缺损的经验。
2008年至2013年，12例患者使用了12个组织扩张器进行面部修复。手术分两步进行。第一步，将扩张器置于颈部皮下并适时扩张，以形成足够的多余皮肤和软组织。第二步，在切除病变后，将扩张皮瓣转移至面中下部修复缺损。
在过去5年中，所有12例面中下部有病变的患者均采用上述技术成功进行了面部修复。随访时间为6至24个月。术后皮瓣未出现收缩，且未复发挛缩。颌颈角外观正常。除2例患者皮瓣远端边缘出现轻微坏死外，所有皮瓣均存活良好，未观察到其他严重并发症。美学效果在10例患者（83.3%）中被评为非常好，2例患者（16.7%）中被评为良好。
颈部扩张皮瓣的应用被证明是修复面中下部面部缺损的有效方法。该技术在修复面部周边美学单元方面非常可靠。
