Integrated expanded flaps for the chest and trunk reconstruction in patients with post-burn total and subtotal scars

Abstract

The aim — to improve the surgical treatment results in patients with post‑burn total and subtotal deformations of the chest and trunk with expanded flaps based on axial and perforating vessels.Materials and methods. The work is based on examinations of 16 patients (10 women and 6 men) with subtotal and total post‑burn deformities of the chest (8), abdominal wall (4), chest and abdominal wall (3) and the posterior lateral surface of the trunk (1) in age from 5 to 38 years (average 15.3 years). To eliminate the deformities, a pre‑expanded 21 integrated flaps based on the perforator vessels of the lateral artery of the chest and VI‑VII of the middle perforators of the intercostal arteries (5), VI‑X of the middle (6) and VI‑X of the anterior (3) perforators of the intercostal arteries, I — II perforators of the lumbar arteries (6) and perforators of the deep lower epigastric artery (1) were used.Results and discussion. The possibility of the integrated expanded flaps formation from the lateral surface of the chest and trunk on the basis of axial and perforator vessels based on axial and perforator adjacent areas due to the reconstruction of the vascular bed and tissue hemodynamic was shown.Conclusions. Clinical data of use of integrated expanded flaps from the lateral surface of the chest and abdominal wall based on axial or perforator vessels and the vascular network of perforator vessels of adjacent tissues allowed to obtain good (73.8 %) and satisfactory (26.2 %) results in the nearest and good (64.3 %) and satisfactory (33.7 %) results in the remote follow‑up period.