Abstract
BackgroundThe thin and pliable skin of the neck is a region with multidirectional activity, and postburn scar contractures tend to form there easily. The supraclavicular flap is used to correct neck scar contractures. Its main vascular supply is the supraclavicular artery, and it can be harvested as either a skin pedicle flap or an island flap (vascular pedicle flap).ObjectiveIn this article, a total of 41 flaps are studied retrospectively and their efficacy in reconstruction of post-burn neck scar contractures is discussed. Also donor-site morbidity, patient satisfaction, and complications were evaluated.Patients and MethodsBetween November of 2004 and January of 2009, 41 supraclavicular flaps were used for reconstructions in 32 patients at the authors’ hospital. Twenty-four of these flaps were skin pedicle flaps, and 17 were island flaps. The range of flap size was 18 ± 6 cm in length, and 9 ± 3 cm in width. Pre-expansion was performed in 14 flaps. Primary closure of donor site was performed in 35 flaps.ResultsThirty-seven of the 41 flaps survived completely, but there were three cases of distal necrosis (10-30%), and one case of complete flap necrosis. Twenty-nine of the 32 patients were satisfied with both the functional and aesthetic results.ConclusionsScarring of the neck produces problems with function, and appearance. In our view, the supraclavicular flap, a thin flap of good texture, is an excellent and highly reliable flap for covering defects of the anterior neck. This flap is easy to harvest, with good functional and aesthetic results.
Highlights
The thin and pliable skin of the neck is a region with multidirectional activity, and postburn scar contractures tend to form there
With expanded supraclavicular skin flap, we can increase its size and reach. This method is easier to perform compared with the supraclavicular island flap, and is attractive in patients who are at risk for poor or delayed healing, such as smokers or patients with complex medical histories in whom longer, and more complex procedures may be associated with increased risk (b)
In the 1970s, was criticized by Blevins and Luce [11] because of the high incidence of necrosis of the distal part of the flap when elevated in its maximal extension
Summary
The thin and pliable skin of the neck is a region with multidirectional activity, and postburn scar contractures tend to form there . The supraclavicular flap, a thin flap of good texture, is an excellent and highly reliable flap for covering defects of the anterior neck This flap is easy to harvest, with good functional and aesthetic results. The thin and pliable skin of the neck is a region with multidirectional activity, and postoperative scar contractures tend to form there . Scars in this area may lead to restriction in the range of motion of the neck and to abnormal function of the lower face, such as lip incompetence, and reduced facial expression. Skin expansion in the donor region allowed coverage of the larger unit of the anterior neck and modified the morphologic characteristics of the transferred flap through capsule formation, and fatty tissue atrophy, which was benefi-
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