Zhou Zheng-Bing, Pan Ding, Wu Pan-Feng, Yu Fang, Pang Xiao-Yang, Xiao Yong-Bing, Zeng Lei, Kachniarz Bartlomiej, Tang Ju-Yu
Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, MD.
Ann Plast Surg. 2018 Jun;80(6):634-638. doi: 10.1097/SAP.0000000000001391.
This study investigates the feasibility and clinical impact of the microdissected thin perforator skin flap strategy on bulky and deformed skin flaps during second-stage revision surgery.
Seventeen patients were selected and underwent the microdissected thin perforator skin flap technique to treat bulky and deformed skin flaps after free flap reconstruction between October 2013 and October 2015. Perforator vessels were isolated and protected under a microscope. Subdermal fat with a thickness of 4 mm to 7 mm was preserved, and excess adipose tissue was resected.
No skin flap necrosis was observed after the operation in all 17 patients, and all wounds healed without complications. Patients were followed up for 3 to 24 months, with an average follow-up time of 10 months. The skin flaps maintain normal color and texture. Both appearance and function of the recipient sites were improved significantly.
The utilization of microdissected thin perforator flap technique to further thin bulky skin flaps at the second stage can be effective in a single operation. The blood supply of all free flaps was preserved, with no evidence of necrosis or healing complications. This technique offers an effective approach for secondary thinning of bulky free flaps.
