Preexpanded Pedicle Medial Arm Flap: An Alternative Method of Massive Facial Defect Reconstruction

Abstract

This article aims to describe the application of the preexpanded pedicle medial arm flap in facial reconstruction and the authors' experiences solving the problems that appeared during the whole reconstruction procedure. A tissue expander was placed in the medial arm region and serially inflated for approximately 3months. Then, the preexpanded flap was prepared as a tube flap and transferred to the face. The pedicle was divided 3weeks later, and the flap was used to resurface the facial defect. Since 2005, the preexpanded pedicle medial arm flap has been used in face reconstruction for 9 patients ranging in age from 9 to 31years. There were no perioperative complications or flap loss. The donor sites all were closed directly. In the authors' experience, a flap as large as 10×20cm could be raised and safely transferred without flap necrosis. The results indicate that the application of the preexpanded pedicle medial arm flap can be one option for reconstruction of massive facial defects.