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[Effects of expanded frontal-parietal pedicled flap in reconstructing cervical scar contracture deformity in children after burns].

作者信息

Xia C D, Xue J D, Xing P P, Guo H N, Cao D Y, Xie J F, Han D W, Di H P

机构信息

Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China.

出版信息

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022 May 20;38(5):454-461. doi: 10.3760/cma.j.cn501120-20210507-00172.


DOI:10.3760/cma.j.cn501120-20210507-00172
PMID:35599421
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11705279/
Abstract

To explore the effects of expanded frontal-parietal pedicled flap in reconstructing cervical scar contracture deformity in children after burns. A retrospective observational study was conducted. From January 2015 to December 2020, 18 male children with cervical scar contracture deformity after burns who met the inclusion criteria were admitted to Zhengzhou First People's Hospital, aged 4 to 12 years, including 10 cases with degree Ⅱ cervical scar contracture deformity and 8 cases with degree Ⅲ scar contracture deformity, and were all reconstructed with expanded frontal-parietal pedicled flap. The surgery was performed in 3 stages. In the first stage, a cylindrical skin and soft tissue expander (hereinafter referred to as expander) with rated capacity of 300 to 500 mL was placed in the frontal-parietal region. The expansion time was 4 to 6 months with the total normal saline injection volume being 2.1 to 3.0 times of the rated capacity of expander. In the second stage, expander removal, scar excision, contracture release, and flap transfer were performed, with the flap areas of 18 cm×9 cm to 23 cm×13 cm and the secondary wound areas of 16 cm×8 cm to 21 cm×11 cm after scar excision and contracture release. After 3 to 4 weeks, in the third stage, the flap pedicle was cut off and restored. The rated volume of placed expander, total normal saline injection volume, type of vascular pedicle of flap, survival of flap and reconstruction of scar after the second stage surgery were recorded. The neck range of motion and cervico-mental angle were measured before surgery and one-year after surgery. The appearance of neck, occurrence of common complications in the donor and recipient sites of children, and satisfaction of children's families for treatment effects were followed up. Data were statistically analyzed with paired sample test. All the patients successfully completed the three stages of operation. The rated volume of implanted expander was 300 mL in 6 children, 400 mL in 9 children, and 500 mL in 3 children, with the volume of normal saline injection being 630 to 1 500 mL. The type of vascular pedicle of flap was double pedicle in 13 cases and was single pedicle in 5 cases. All the flaps in 17 children survived well, and the secondary wounds after neck scar excision and contracture release were all reconstructed in one procedure. In one case, the distal blood supply of the single pedicled flap was poor after the second stage surgery, with necrosis of about 2.5 cm in length. The distal necrotic tissue was removed on 10 days after the operation, and the wound was completely closed after the flap was repositioned. In the follow-up of 6 months to 3 years post operation, the cervical scar contracture deformity in 18 children was corrected without recurrence. The flap was not bloated, the texture was soft, and the appearances of chin and neck were good. The range of motion of cervical pre-buckling, extension, left flexion, and right flexion, and cervico-mental angle in one year after operation were improved compared with those before operation (with values of 43.10, 22.64, 27.96, 20.59, and 88.42, respectively, <0.01). The incision in the frontal donor site was located in the hairline, the scar was slight and concealed. No complication such as cranial depression was observed in expander placement site, and the children's families were satisfied with the result of reconstruction. Application of expanded frontal-parietal pedicled flap in reconstructing the cervical scar contracture deformity in children after burns can obviously improve the appearance and function of neck, with unlikely recurrence of postoperative scar contractures, thus it is an ideal method of reconstruction.

摘要

相似文献

[1]
[Effects of expanded frontal-parietal pedicled flap in reconstructing cervical scar contracture deformity in children after burns].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022-5-20

[2]
[Clinical effects of single pedicle transfer of expanded axial flap across the midline of the frontal-parietal region in reconstruction of large scar deformities in the face and neck].

Zhonghua Shao Shang Za Zhi. 2020-9-20

[3]
[Clinical effects of expanded flaps in reconstructing scar contracture deformities in the face and neck after extensive burns].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2023-9-20

[4]
[Aesthetic reconstruction of the scar contracture deformity in chin and neck with expanded flaps based on the "MRIS" principle].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022-4-20

[5]
[Clinical effects of free transplantation of expanded ilioinguinal flaps in the reconstruction of severe scar contracture deformity after extensive burns].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022-4-20

[6]
[Clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022-4-20

[7]
[Clinical effects of free transplanted pre-expanded scapular flap in reconstructing scar contracture deformity of neck].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2023-9-20

[8]
[Clinical application of expanded internal mammary artery perforator flap combined with vascular supercharge in reconstruction of faciocervical scar].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022-4-20

[9]
[Expanded flaps with vascular anastomosis for the treatment of scar contracture deformities of extensively burned patients].

Zhonghua Shao Shang Za Zhi. 2019-6-20

[10]
[Clinical effects of free pre-expanded internal thoracic artery perforator pedicled deltopectoral flap transfer in facial scar reconstruction].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2023-3-20

本文引用的文献

[1]
[Clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022-4-20

[2]
[Clinical application of expanded internal mammary artery perforator flap combined with vascular supercharge in reconstruction of faciocervical scar].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022-4-20

[3]
[Application of skin and soft tissue expansion in repairing pediatric patients with superficial defects].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022-4-20

[4]
Tissue expansion in pediatric patients: a 10-year review.

J Pediatr Surg. 2018-9-18

[5]
The lived experience and quality of life with burn scarring-The results from a large-scale online survey.

Burns. 2018-11

[6]
A qualitative exploration of psychosocial specialists' experiences of providing support in UK burn care services.

Scars Burn Heal. 2018-3-20

[7]
Tissue Expansion in Children.

Semin Plast Surg. 2016-11

[8]
Pre-expanded Transverse Cervical Artery Perforator Flap.

Clin Plast Surg. 2017-1

[9]
Reconstruction of cica-contracture on the face and neck with skin flap and expanded skin flap pedicled by anterior branch of transverse cervical artery.

J Craniomaxillofac Surg. 2016-9

[10]
The Clinical Application of Preexpanded and Prefabricated Super-Thin Skin Perforator Flap for Reconstruction of Post-Burn Neck Contracture.

Ann Plast Surg. 2016-2

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