Reconstruction of facial and napex scar with expanded cervico-acromial flap

Abstract

Objective To discuss the feasibility of transferring neck- shoulder peak area expanded skin flap to facial and napex area of removed scar tissue, and to observe the therapeutic effect of expanded cervico-acromial flaps for facial and napex scar. Methods In the first stage, the soft tissue expanders (ranging from 600 ml to 800 ml in volume) were implanted under the deep fascia of the cervio-acromion region. The blood vessle that located at the base of the flap were protected. In the second stage, the expanded flap, pedicled by the lateral neck (supraclavicular artery), was elevated and rotated by 90-180 degree to the facial or napex defects. The donor site of the flap was closed primarily or by free skin graft. Results A lot of 28 patients, with napex scar in 5 cases, facial scar in 23 cases, were treated by the expanded cervico-acromial flaps, the length of which ranged from 5-10 cm, the width 15-20 cm. All flaps survived with color and texture matched well with the surrounding skin tissue. Conclusions The blood supply of the cervico-acromial flap is stable and abundant with constant perforators. It is a reliable technique for facial and napex reconstruction. Key words: Facial scar; Neck scar; Cervico-acromial flap; Expand flap