Platysma flap using dual skin paddles

Platysma myocutaneous flap revised in the free flaps era: clinical experience in 61 patients

“…The platysma is a thin quadrangular-shaped muscle that lies in the superficial fascia of the neck. The muscle fibres arise from the superficial fascia of the pectoralis major and deltoid muscles, cross the clavicle and run obliquely inserting at the angle of the mandible, inferior part of the cheek, and depressor muscles of the lip [1][2][3][4][5][6][7][8][16][17][18][19][20][21] . The main artery supplying the platysma is the submental branch of the facial artery 3,4 .…”

“…Considering the main vascular pedicle, two different variants of MPF can be harvested for head and neck reconstruction: the posterior flap based on branches of the occipital artery and the superior or vertical flap based on the submental branch of facial artery; the latter has the widest diffusion in surgical practice [2][3][4] . MPF has applications in reconstructing a large variety of head and neck defects and, in particular, has shown to be a good surgical option for the reconstruction of small to medium, and, rarely, large sized (15-75 cm 2 ) mucosal defects of the oral cavity [1][2][3][4][5][6][7][8][16][17][18][19][20][21] . The thinness and pliability of the muscle-skin paddle unit make the platysma flap particularly suitable for tailoring defects of floor of the mouth, cheek mucosa, and gum to prevent post-operative functional impairment, due to primary closure with excessive tension 1,2 .…”

“…The thinness and pliability of the muscle-skin paddle unit make the platysma flap particularly suitable for tailoring defects of floor of the mouth, cheek mucosa, and gum to prevent post-operative functional impairment, due to primary closure with excessive tension 1,2 . According to the literature, other sites suitable for reconstruction with MPF are the lip, lateral wall of the oro-hypopharynx, and low facial skin defects [1][2][3][4][5][6][7][8][16][17][18][19][20][21] . When compared to other flaps such as the ALTFF, RFFF, and pectoralis major myocutaneous pedicle flap, the MPF is less bulky, with better skin colour match; the time for harvesting is shorter, and donor site morbidity is lower 2,3 .…”

“…When compared to other flaps such as the ALTFF, RFFF, and pectoralis major myocutaneous pedicle flap, the MPF is less bulky, with better skin colour match; the time for harvesting is shorter, and donor site morbidity is lower 2,3 . However, several anatomical and oncological controversies have limited its use [1][2][3][4][5][6][7][8][16][17][18][19][20][21] . The first matter of debate regards blood supply of the flap.…”

Reconstruction of Soft Tissue Defects on the Face, Neck, and Chest by Expanded Cervico-Acromial Flap

“…First, there is no known dominant axial vessel in the platysma flap. 14 Second, it is not large enough to cover a big wound: it can cover the wound area is in the range of 50 to 75 cm 2 . 13 Finally, for this flap, a long and narrow flap, especially crossing the neck midline, is more likely to lead to poor outcomes.…”