Total Face Reconstruction Using a Pre-expanded, Bilateral, Extended, Parascapular Free Flap

Abstract

A 37-year-old male sustained extensive, self-inflicted gasoline burns to his head, face, chest, upper extremities, and anterior thighs. Although he underwent initial resuscitation and skin grafting at a regional burn center, he presented to our clinic with thick, unstable burn scars covering his face and scalp. He had multiple functional and esthetic needs that are described. He required approximately 30 x 35 cm of skin to resurface his entire face and anterior scalp. His back and buttocks were his only unscarred, potential donor sites. Authors have described use of a bilateral parascapular free flap for similar deformities. This patient required pre-expansion of this free flap to maximize available tissue and minimize the donor defect. This technique provided this patient with a large area of healthy skin and soft tissue that will ultimately provide this patient with an improved functional and esthetic result.