Touch-up Procedures Research Articles

Facial Artery Perforator Flap for Perioral and Perinasal Oncologic Defect Reconstruction: Surgical Technique and Postoperative Outcomes.

Facial artery perforator (FAP) flap is a versatile and reliable one-step facial reconstruction technique. However, its full potential remains underutilized due to a lack of clear guidelines and rigorous technique requirements. This study report the use of FAP flaps in our centre for the management of perioral and nasal oncologic defects, focusing on surgical technique performed and post-operative management. We conducted a retrospective review of all patients who underwent reconstruction with a perioral or perinasal FAP flap only following tumor resection over a 4-year period (n = 29). Parameters measured included flap survival, complication rates, surgical technique performed, and the need for touch-up procedures. Patients were grouped based on age, defect size, and location and outcomes were compared across these groups. The mean histological tumor defect area was 331 mm2. During at least 6 months of follow-up, no local recurrence was observed. Twenty-seven (93.1%) flaps survived completely. Major postsurgical complications occurred in seven (23.8%) patients, including complete flap necrosis (1), partial flap necrosis (1), flap collapse (1), venous congestion (1), wound dehiscence (1), and local infection (2). A higher complication rate was associated with nose tip defects (80.0% vs. 12.5%, p = 0.007). Touch-up procedures were more frequently required for reconstructions involving the nasal sidewall and dorsum (53.8% vs. 13.3%, p = 0.04). Based on our experience, the FAP flap is highly effective for the reconstruction of the upper lip, nasolabial fold, and certain oncologic nasal defects. However, specific defect locations, such as the nose tip, may be associated with higher complication rates, necessitating careful patient selection and surgical planning.

Long-term follow-up of thoracoscopic ablation in long-standing persistent atrial fibrillation.

OBJECTIVESCatheter ablation of long-standing persistent atrial fibrillation (LSPAF) remains challenging, with suboptimal success rates obtained following multiple procedures. Thoracoscopic ablation has shown effective at creating transmural lesions around the pulmonary veins and box; however, long-term rhythm follow-up data are lacking. This study aims, for the first time, to assess the long-term outcomes of thoracoscopic pulmonary vein and box ablation in LSPAF.METHODSRhythm follow-up consisted of continuous rhythm monitoring using implanted loop recorders or 24-h Holter recordings. Rhythm status and touch-up interventions were assessed up to 5 years.RESULTSSeventy-seven patients with symptomatic LSPAF underwent thoracoscopic ablation in 2 centres. Freedom from atrial arrhythmias at 5 years was 50% following a single thoracoscopic procedure and 68% allowing endocardial touch-up procedures (performed in 21% of patients). The mean atrial fibrillation burden in patients with continuous monitoring was reduced from 100% preoperatively to 0.1% at the end of the blanking period and 8.0% during the second year. Antiarrhythmic drug use decreased from 49.4% preoperative to 12.1% and 14.3% at 2 and 5 years, respectively (P < 0.001). Continuous rhythm monitoring resulted in higher recurrence detection rates compared to 24-h Holter monitoring at 2-year follow-up (hazard ratio: 6.5, P = 0.003), with comparable recurrence rates at 5-year follow-up.CONCLUSIONSThoracoscopic pulmonary vein and box isolation are effective in long-term restoration of sinus rhythm in LSPAF, especially when complemented by endocardial touch-up procedures, as demonstrated by the 68% freedom rate at 5 years. Continuous rhythm monitoring revealed earlier, but not more numerous documentation of recurrences at 5-year follow-up.

Botulinum Toxin Type A Reconstituted with Lidocaine: A Report of 1000 Consecutive Cases

(1) Background: There is an increasing demand for a reversal of the aging process and, nowadays, more patients are seeking minimally invasive methods instead of surgery to meet this goal. The purpose of this paper is to evaluate the predictability of the off-label aesthetic use of botulinum toxin type A (BoNTA) reconstituted with lidocaine. (2) Methods: One thousand treatments, between January 2010 and January 2020, with BoNTA reconstituted with lidocaine for the rejuvenation of the upper third of the face, were performed and retrospectively evaluated. (3) Results: A few seconds after the BoNTA injections, the effect of muscle paralysis was seen in all cases; this allowed providing an optimal symmetric result with no need for a touch-up procedure at the control after three weeks. A burning sensation during the injections was claimed by almost all patients. Major complications were not registered. No touch-up procedures were required. (4) Conclusions: The results of this study show how the reconstitution of BoNTA with lidocaine may avoid imperfect results after the injections; the immediate feedback on the extent of paralysis to be expected from the chemodenervation action of BoNTA allows the physician to have immediate control of the final result.

Long-Term Functional Outcomes Following Septal Extension Grafting in Open Rhinoplasty

BACKGROUND: Septal extension grafts in rhinoplasty can successfully support tip projection/position, tension the lower lateral cartilages, and thereby open the nasal airway. Since long cartilage grafts under tension may warp or collapse over time, long-term outcomes must be evaluated in these patients. We aimed to assess long-term functional outcomes in a large series of patients who underwent septal extension grafting. METHODS: Retrospective chart review was performed on all patients who underwent an open rhinoplasty approach that included use of a septal extension graft performed by a single surgeon from February 2013 through December 2018. Patients with a minimum 12-month postoperative follow-up were included. Pre- and postoperative functional outcomes including history of nasal obstruction, snoring, sleep apnea, sinus congestion, and sinus headaches were recorded. Patient demographics, types of grafts used, patient complaints, readmission, and reoperation rates were recorded. Statistical analysis was performed using McNemar’s test. RESULTS: Of the 385 patients who underwent open rhinoplasty with septal extension grafting during the study period, 127 with adequate follow-up were included; 72% females, 28% males, mean age 28 (range: 5–72) years. 83.5% primary rhinoplasty, 16.5% secondary rhinoplasty. Mean follow-up was 24.2 (range: 11.2–74.0) months. 10.2% had history of cleft lip, 49.6% had history of nasal trauma. Other graft types used included tip/infratip (92.9%), dorsal onlay (90.6%), spreader graft/flap (92.1%), and columellar strut/onlay (7.9%). 85.0% underwent a turbinate outfracture/coblation. Patients reported an improvement in (pre- versus postoperative) nasal airway obstruction (89.8% versus 11.8%; P < 0.001), snoring (55.1% versus 1.6%; P < 0.001), sleep apnea (5.5% versus 0.0%; P = 0.016), sinus congestion (45.7% versus 15.7%; P < 0.001), and sinus headaches (6.3% versus 0.0%; P = 0.008). All patients reported an improvement in aesthetic appearance, with 7.9% undergoing touch-up procedures such as filler or fat injection to smooth a minor contour deformity. 6.5% of patients in this cohort required reoperation; the most common reasons for reoperation were for nasal deformity/deviation (72.0%), persistent airway obstruction (20.0%), and scar revision/dermabrasion (8.0%). Only 3.1% of noncleft, nontrauma patients required revision. No patients reported worsening of nasal airway patency. CONCLUSIONS: Septal extension grafts, when applied in open rhinoplasty patients, can reliably and significantly improve functional outcomes in addition to the aesthetic benefits to tip projection and rotation. Quantitative analysis of nasal airway changes following septal extension grafting will be presented.

Mirror-Imaged Rapid Prototype Skull Model and Pre-Molded Synthetic Scaffold to Achieve Optimal Orbital Cavity Reconstruction

Reconstruction of traumatic orbital wall defects has evolved to restore the original complex anatomy with the rapidly growing use of computer-aided design and prototyping. This study evaluated a mirror-imaged rapid prototype skull model and a pre-molded synthetic scaffold for traumatic orbital wall reconstruction. A single-center retrospective review was performed of patients who underwent orbital wall reconstruction after trauma from 2012 to 2014. Patients were included by admission through the emergency department after facial trauma or by a tertiary referral for post-traumatic orbital deformity. Three-dimensional (3D) computed tomogram-based mirror-imaged reconstruction images of the orbit and an individually manufactured rapid prototype skull model by a 3D printing technique were obtained for each case. Synthetic scaffolds were anatomically pre-molded using the skull model as guide and inserted at the individual orbital defect. Postoperative complications were assessed and 3D volumetric measurements of the orbital cavity were performed. Paired samples t test was used for statistical analysis. One hundred four patients with immediate orbital defect reconstructions and 23 post-traumatic orbital deformity reconstructions were included in this study. All reconstructions were successful without immediate postoperative complications, although there were 10 cases with mild enophthalmos and 2 cases with persistent diplopia. Reoperations were performed for 2 cases of persistent diplopia and secondary touchup procedures were performed to contour soft tissue in 4 cases. Postoperative volumetric measurement of the orbital cavity showed nonsignificant volume differences between the damaged orbit and the reconstructed orbit (21.35 ± 1.93 vs 20.93 ± 2.07 cm(2); P = .98). This protocol was extended to severe cases in which more than 40% of the orbital frame was lost and combined with extensive soft tissue defects. Traumatic orbital reconstruction can be optimized and successful using an individually manufactured rapid prototype skull model and a pre-molded synthetic scaffold by computer-aid design and manufacturing.

Facial contour deformity correction with microvascular flaps based on the 3-dimentional template and facial moulage

Introduction:Facial contour deformities presents with varied aetiology and degrees severity. Accurate assessment, selecting a suitable tissue and sculpturing it to fill the defect is challenging and largely subjective. Objective assessment with imaging and software is not always feasible and preparing a template is complicated. A three-dimensional (3D) wax template pre-fabricated over the facial moulage aids surgeons to fulfil these tasks. Severe deformities demand a stable vascular tissue for an acceptable outcome.Materials and Methods:We present review of eight consecutive patients who underwent augmentation of facial contour defects with free flaps between June 2005 and January 2011. De-epithelialised free anterolateral thigh (ALT) flap in three, radial artery forearm flap and fibula osteocutaneous flap in two each and groin flap was used in one patient. A 3D wax template was fabricated by augmenting the deformity on facial moulage. It was utilised to select the flap, to determine the exact dimensions and to sculpture intraoperatively. Ancillary procedures such as genioplasty, rhinoplasty and coloboma correction were performed.Results:The average age at the presentation was 25 years and average disease free interval was 5.5 years and all flaps survived. Mean follow-up period was 21.75 months. The correction was aesthetically acceptable and was maintained without any recurrence or atrophy.Conclusion:The 3D wax template on facial moulage is simple, inexpensive and precise objective tool. It provides accurate guide for the planning and execution of the flap reconstruction. The selection of the flap is based on the type and extent of the defect. Superiority of vascularised free tissue is well-known and the ALT flap offers a versatile option for correcting varying degrees of the deformities. Ancillary procedures improve the overall aesthetic outcomes and minor flap touch-up procedures are generally required.

1,000 Consecutive Cases of Laser-Assisted Liposuction and Suction-Assisted Lipectomy Managed With Local Anesthesia

Advances in suction-assisted lipectomy (SAL) include improved instrumentation, better understanding of fluid dynamics, and an improved concept of appropriate indications. The tumescent technique uses subcutaneous injection of isotonic fluid containing vasoconstrictive and analgesic agents and is proved to be safe, with low morbidity and mortality rates. Laser-assisted liposuction (LAL) using local infiltration of an anesthetic and no general anesthesia or sedation has been developed, with claims of fat destruction and skin tightening. This study aimed to review 1,000 consecutive cases of LAL and SAL performed with the patient under local anesthesia and to determine whether this represents a safe technique with few complications. During a period of 22 months, 581 consecutive patients (486 females and 95 males) underwent 1,000 LAL/SAL operations, 545 of whom had multiple procedures performed. None of the patients had a body mass index (BMI) higher than 30 kg/m2. The patients ranged in age from 18 to 62 years. The fat aspirate ranged from 50 to 1,400 ml. Patients were given an oral sedative, an antibiotic, and an analgesic. Ringer's lactate solution containing lidocaine and epinephrine was injected into the subcutaneous space. The 1,064-nm and/or 1,320-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was used for laser lipolysis followed by SAL using standard and/or power-assisted liposuction (PAL) cannulas. The treated areas included the neck, triceps, male breast, midback, flanks, axilla, abdomen, mons pubis, thighs, presacrum, and knees. No patient was administered intravenous sedation or general anesthesia. The average number of areas treated was 1.8, and no major complications or mortalities were observed. There were three burns, two infections, one hematoma, and one seroma. A total of 73 secondary procedures were performed (7.3%). No tertiary procedures were required. For appropriately selected patients, comparable results can be obtained with an excellent safety profile and short recovery period using LAL and SAL with the patient under local anesthesia. The awake patient is able to participate in body positioning and to provide physiologic monitoring. No major complications occurred in this series. The burn and hematoma complications occurred in the first 25 cases and may have been related to a learning curve. One case of cellulitis occurred in the triceps region, and a second infection occurred in the abdomen. Both responded to antibiotics. Altogether, 73 touch-up procedures (7.3%) were performed. The amounts of fat removal were comparable with the volumes obtained using traditional liposuction. In conclusion, this series demonstrated that LAL/SAL using local anesthesia is a safe procedure for selected patients, with acceptably low morbidity and revision rates. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266.

Polyacrylamide Gel for Facial Wasting Rehabilitation: How Many Milliliters per Session?

Facial lipoatrophy is most distressing for HIV patients in pharmacologic treatment. Nonabsorbable fillers are widely used to restore facial features in these patients. We evaluated the safety and aesthetic outcomes of two samples of HIV+ patients affected by facial wasting who received different filling protocols of the nonabsorbable filler Aquamid® to restore facial wasting. Thirty-one HIV+ patients affected by facial wasting received injections of the nonabsorbable filler Aquamid for facial wasting rehabilitation. Patients were randomly divided into two groups: A and B. In group A, the facial defect was corrected by injecting up to 8 ml of product in the first session; patients were retreated after every 8th week with touch-up procedures until full correction was observed. In group B, facial defects were corrected by injecting 2 ml of product per session; patients were retreated after every 8th week until full correction was observed. Patients of group A noted a great improvement after the first filling procedure. Patients in group B noted improvement of their face after four filling procedures on average. Local infection, foreign-body reaction, and migration of the product were not observed in either group during follow-up. The rehabilitation obtained with a megafilling session and further touch-up procedures and that with a gradual build-up of the localized soft-tissue loss seem not to have differences in terms of safety for the patients. However, with a megafilling session satisfaction is achieved earlier and it is possible to reduce hospital costs in terms of gauze, gloves, and other items.

Achalasia - An Update

Achalasia is an esophageal motility disorder of unknown cause, characterized by aperistalsis of the esophageal body and impaired lower esophageal sphincter relaxation. Patients present at all ages, primarily with dysphagia for solids/liquids and bland regurgitation. The diagnosis is suggested by barium esophagram and confirmed by esophageal manometry. Achalasia cannot be cured. Instead, our goal is to relieve symptoms, improve esophageal emptying and prevent the development of megaesophagus. The most successful therapies are pneumatic dilation and surgical myotomy. The overall success rate of graded pneumatic dilation is 78%, with women and older patients responding best. Laparoscopic myotomy, usually combined with a partial fundoplication, has an overall success rate of 87%. Young patients, especially men, are the best candidates for surgical myotomy. Botulinum toxin injection into the lower esophageal sphincter and smooth muscle relaxants are usually reserved for older patients or those with co-morbid illness. The prognosis for achalasia patients to return to near normal swallowing is good, but the disease is rarely "cured" with a single procedure and intermittent touch-up procedures may be required.

Autologous Fat Grafting

To provide quantitative objective data demonstrating the longevity and amount of volume augmentation in the midface obtained with autologous fat grafting. A prospective analysis of all patients who underwent autologous fat transfer to the midface region at our private practice and were followed up for at least 1 year. Three-dimensional imaging was performed with a Canfield Scientific Vectra camera and software, with quantitative volume measurements evaluating the amount of postoperative volume change. Thirty-three patients (66 hemiface-midface regions) were included in the study. The mean follow-up time was 16 months. The mean amount of autologous fat injected into each midface region was 10.1 mL. Overall, the mean absolute volume augmentation measured at their last postoperative visit was 3.3 mL (31.8% take). There was variability between patients in the volume amount and percentage that remained. Touch-up procedures were performed in 8 patients. To our knowledge, this study is the first clinical quantification of autologous fat transfer and/or grafting in the literature that provides definitive evidence on the amount as well as the resultant longevity in the midface. Autologous fat transfer to the midface has definite long-term volume augmentation results. On average, approximately 32% of the injected volume remains at 16 months. However, some variability exists in the percentage of volume that remains that may require a touch-up procedure.

Lipografting: Autologous Fat Grafting for Total Facial Rejuvenation

Surgeons who perform facial rejuvenation procedures have long recognized the importance of volume enhancement. The primary manifestation of aging is loss of subcutaneous tissue, especially the atrophy of fat, which directly contributes to laxity of skin. Autologous fat transplantation has been attempted for over a century with varying degrees of success but more recent techniques have provided more predictable, reproducible, and even permanent results. Fat is an ideal tissue filler substance because it is living tissue and because it is from the patient's own body it is nonallergenic. My technique has evolved over an 11-year period in more than 1800 patients. The procedure can be performed alone as a total facial rejuvenation or in combination with facelift or other facial surgery. The technique requires minimally traumatic fat harvesting, fat preparation, and multilevel facial infiltration. Excess fat not used in the initial procedure is frozen and stored at -16 degrees C and can be used successfully for minor touch-up procedures. Preoperative evaluation of the patient and their understanding of the benefits and limitations of volume restoration surgery is imperative. Structural improvement to the main support areas of the face in the appropriate aesthetic proportions is of prime importance.

Thyroplasty revisions: frequency and predictive factors

Summary: Thyroplasty is the most commonly performed type of laryngeal framework surgery, and the surgical indications are gradually being expanded. Although many reports have described thyroplasty results and rates of success, no study has attempted to determine predictors of the need for revisions or other secondary surgical procedures. Methods: Retrospective review of 118 primary thyroplasty procedures performed on 96 patients. Secondary surgical procedures were divided into planned second-stage procedures (all fat implantation due to scarring), touchup procedures (primarily fat or collagen injections to close localized glottic gaps), and thyroplasty revisions (for implant extrusion or slippage). Statistical analysis was performed via the chi-squared technique with p<0.05 considered significant. Results: 96 patients underwent thyroplasty, 58 for vocal fold paresis or paralysis and 38 for other indications. Thirty-two (33%) patients underwent secondary surgical procedures, including 4 planned second stage procedures, and 6 patients with progression of their underlying disease. Thirty-two secondary procedures were performed in the other 22 patients. Professional singers were found to be more likely to require touchup or planned second-stage procedures ( p = 0.029). Patients with abnormal preoperative noise-to-harmonic ratios were more likely to undergo secondary surgeries ( p = 0.039). Maximum phonation time was not associated with need for secondary surgery. Implant material did not influence revision rates. Conclusions: Professional singers and those patients with severe voice disorders (as measured by more abnormal noise-to-harmonic ratios) are more likely to undergo secondary surgical procedures. The choice of implant material does not affect need for secondary surgical procedures.

The Benefits of Powered Liposuction Versus Traditional Liposuction

BACKGROUND There is much debate about the safety of liposuction as well as the efficacy and risk:benefit ratio of newer devices used in this procedure. OBJECTIVE To determine if there are any benefits in terms of safety and efficacy of power reciprocating cannulas compared to traditional manual liposuction cannulas. METHODS Patients served as their own controls in a paired comparison analysis of power liposuction cannulas and traditional liposuction cannulas. RESULTS Power cannulas significantly reduced procedure times, intraoperative pain, and surgeon fatigue, and increased the amount of fat aspirated per minute. Power cannulas also decreased postoperative pain, ecchymoses, and edema, as well as resulting in higher patient satisfaction scores. CONCLUSION Power liposuction cannulas produce significantly faster recovery times for patients, allow faster procedure times, and reduce surgeon fatigue, resulting in safer and more precise surgery. A lower incidence of touch-up procedures is likely due to these benefits.

Fat Grafting: Techniques and Uses in Different Anatomic Areas

Introduction: Fat grafting can be used to place fat in the face, hands, breasts, buttocks, calves, and genitals for cosmetic purposes. The procedure is also used to reconstruct some congenital abnormalities (such as hemifacial atrophy) or to correct selected traumatic facial defects; it may also be used in combination with other surgical procedures (facelifts) or as part of a facial rejuvenation program. We present a review of the steps for fat grafting performed at our center. We have experienced excellent cosmetic results using these techniques. Method and Materials: Of the 867 patients, 367 underwent facial fat transplant; 153 underwent bilateral augmentation mammaplasty by injection (BAMBI); 67 underwent fat injections to the buttock, calves, and other areas of the body; and 280 received fat grafts to the genitalia. Two hundred seventeen patients were men and 63 were women. The operations were performed as ambulatory procedures. Local anesthesia and intravenous (IV) sedation (midazolam plus fentanyl) were used. For all of our patients, we used a modification of the classic Klein formula. All of our patients were operated on under IV sedation. Results: Fat survival was approximately 70% at the end of 1 year. Of the 367 patients undergoing facial fat transplant, 65% were satisfied with the results, and 35% were not satisfied and required a touch-up procedure. Of the 153 undergoing BAMBI, 72% were satisfied with the results, and 28% were not satisfied and required touch-up procedures. Of the 67 patients undergoing fat transplant to the buttocks, calves, and other areas, 76% were satisfied, and 24% were not satisfied and required additional fat grafting. Of the 217 men undergoing genital fat transplant, 82% were satisfied with the results, and 18% were not satisfied. Of the 63 women undergoing genital fat transplant, 86% were satisfied with the results, and 14% were not satisfied. Absorption, infection, and embolism are the most common complications mentioned in the cases of fat injection. Out of 867 total fat transplant operations, absorption occurred after 1 procedure in an average of 30% of cases. In 5 cases, we saw some degree of infection, which was rapidly treated with antibiotics. We did not see any cases of fat embolism. We saw 2 cases of cysts in the dorsum of the hands and 2 in the breasts; these cysts were easily treated with triamcinolone injections. Discussion: When administered properly, autologous fat transplantation is an acceptable procedure resulting in highly satisfied patients. This satisfaction is mostly due to the fact that this process utilizes the patients' own tissue instead of a prosthetic or synthetic implant. Rejection or allergic reaction is not possible with autologous tissue.

The chondrocutaneous ear helical free flap for the reconstruction of the defects of the nasal tip, columella and/or ala

Reconstruction of the full-thickness defect of the tip of nose, columella, and ala has always been a challenge. Local flaps can be used, but this often results in a bulky nose with an unsatisfactory aesthetic appearance requiring secondary surgical procedures. The use of the ear as a donor site for a microvascular free flap, although not general consensus despite structural similarities between the nose and ear, offers a possibility of a good reconstruction for such patients. Five patients presented with composite tissue defects of the tip, columella and ala of the nose resulting from human bites. Reconstruction was performed early in order to avoid possible infection. The free flap was designed and elevated from the upper part of the helix and concha of the opposite ear; the flap matched the traumatic defect on the nose and was based on the anterior auricular branches of the superficial temporal vessels. The free flap was brought to the defect and sutured to the margins. Direct end-to-end anastomosis of both vessels was performed in four patients while a venous grafts was needed in one patient. The donor flap area was closed directly. The follow-up period ranged from six months to five years. The reconstruction was satisfactory as to contour, symmetry and colour match in four patients. The final aesthetic result was obtained by touch-up procedures under local anesthesia. The donor site deformity was minimal. In one patient, the free flap was lost due to venous thrombosis and late reintervention. The chondrocutaneous free flap represents a dependable vascularized composite tissue transfer that offers a straightforward one-stage reconstruction of tissue defects of the tip, columella, and ala of the nose. The additional advantages of freedom in the flap design and structural similarity between the nose and ear makes it an ideal choice for such defects.

The Use of Free Tissue Transfer to Restore Facial Contour

Free tissue transfer offers two-stage augmentation of the facial soft tissues. Nevertheless, it is not unusual to require additional touch-up procedures. An accurate assessment of the preoperative facial deficit will allow for appropriate flap selection and predictable surgical results.

Revision Endoscopic Ethmoidectomy for Chronic Rhinosinusitis

In summary, revision endoscopic surgery for chronic rhinosinusitis can be performed safely by using the middle turbinate (or portion thereof) or the anterior wall of the sphenoid as a landmark. These cases are more difficult and may be more prone to bleeding and scarring. The surgeon should be thoroughly familiar with and not hesitate to switch to conventional techniques in the event of excessive bleeding, proptosis, or a loss of landmarks. Aggressive postoperative care and follow-up, including office endoscopic "touch-up" procedures, may be necessary to maintain control of aggressive disease, along with continued medical management and any indicated immunotherapy.

The Cervico-Humeral Fasciocutaneous Flap

SummaryCervico-humeral fasciocutaneous flap was raised successfully in five patients for the treatment of post-burn contracture of the neck as a single stage procedure. Post-operative splintage was not required. There was no flap loss. Dog-ear correction and Z-plasty were performed as touch-up procedures.