Application of expansion bilateral delto-pectoral thin skin flap in the repair of extensive scar in faciocervical region

Abstract

To contrive an effective method of repairing the scar in bilateral faciocervical region. Between April 2009 and February 2012, 9 patients with large scars on face and neck due to burn and scald were treated. There were 5 cases with face scars and 4 cervical scars. Their average age was 33 years (range: 23-48 years). The disease duration was 6 months to 20 years (mean: 6.5 years). The scar area was 12 cm × 7 cm to 22 cm × 26 cm. The soft tissue expanders (600-800 ml in volume) were implanted in delto-pectoral zone in one-stage operation. In two-stage operation, after the resection of cervical scars, the defects were repaired with delto-pectoral perforator flaps. In 5 facial scar cases, skin flap pedicle division was performed at Week 3. After the resection of scars, all wounds were repaired by expansion flap. The donor sites were sutured directly. The area of removed scar and the status of flap blood supply were observed. And the texture of flaps and patient satisfaction score were followed up for 6-30 months. Mild congestion of flap occurred postoperatively 1 case. The other flaps survived successfully. The flaps of 2 cases appeared bulky after transposition and flap repair was performed at Month 6. The appearance, texture, and color of flaps were similar to those at the donor sites. And there was an excellent match of flaps and recipient place.The patient satisfaction score was 7.6 ± 2.3. All achieved satisfactory functional and aesthetic outcomes. The method has many advantages and its clinical application is both safe and effective.