Application of pre-expanded skin flap in the anterior thoracic region to repair scar in the maxillofacial and cervical region
Objective To investigate the clinical effect and application of pre-expanded skin flap in the anterior thoracic region in the repair of maxillofacial and cervical scars.Methods Retrospective analysis from January 2018 to December 2021,27 cases of maxillofacial and cervical scars were repaired with pre-expanded prothoracic skin flaps in of Plastic and Reconstructive Surgery,The First Affiliated Hospital of Air Force Medical University,the pre-expanded thoracic triangle skin flap with axial blood vessel was divided into two groups:17 cases(21 sides)of pre-expanded thoracic triangle skin flap with internal thoracic artery,2nd,3rd intercostal perforators,10 cases(10 sides)were treated with the expanded transverse cervical flap,which was made from the cutaneous branch of the cervical segment of the transverse cervical artery,to repair the scar of the jaw.Chin and neck According to the length of axial vascular pedicle of the skin flap to repair different scar sites,all of them were treated with one-stage operation by implanting corresponding-sized expander under the skin flap and dilating with water for 2～6 months,in stage Ⅱ or Ⅲ,the expanded skin flap was used to repair the scar contracture.Results In this group,31 dilators were implanted in 27 cases,and the corresponding volume dilators were implanted in the dilatation area ac cording to the prothoracic region during the first stage of operation,and the dilatation was completed successfully after 2～6 months of water injection The blood supply,color and thickness of the skin flap were by the recipient area.The symmetry of the face and neck and the local function,contour,and shape of the skin flap were satisfactory.The size of the pre-expanded thoracic triangle flap was 16 cm×10 cm for the unilateral flap of the mandible,and the pre-expanded transverse cervical flap was 18 cm×15 cm for the unilateral flap of the mandible.All the flaps survived after the operation,and no hematoma,infection,necrosis,or other complications occurred.Conclusion The anterior thoracic skin flap is the best donor site for repairing the scar on the mandible and neck.After pre-expansion,a large area of the skin flap can be obtained,and the color and thickness of the skin flap after transplantation are consistent with the recipient site,the blood supply and color are ensured after the operation.The function,appearance and contour of the jaw and neck recover well after reconstruction.
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