Reconstruction of Skin Defects on the Mid and Lower Face Using Expanded Flap in the Neck

Hu, Xiaogen; Zeng, Gao; Zhou, Yang; Sun, Cheng

doi:10.1097/scs.0000000000003394

Cited by 9 publications

(4 citation statements)

References 9 publications

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“…However, the use of a flap has also been associated with some complications such as necrosis, infection, and hematoma. Hu et al ( 9 ) suggested that the necrosis of the expanded flap was related to its length-to-width ratio and the presence or absence of well-known arteries. Moreover, Chen and colleagues ( 10 ) argued that changing the blood flow of the expanded flap could prevent the necrosis of the flap.…”

Section: Discussionmentioning

confidence: 99%

Testing the circulation of expanded flaps—prevention of necrosis of expanded flaps (a clinic study)

Han

Chen

et al. 2023

Front. Pediatr.

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BackgroundExpanded flaps are commonly used in plastic surgery. Although expanded flaps are more resistant to hypoxia than unexpanded flaps, flap necrosis can sometimes occur, particularly with skin incisions of regular proportion. Distal skin necrosis of the expansion flap can be avoided by careful design; however, the utilization rate of the expansion flap decreases. Consequently, successfully avoiding distal skin flap necrosis remains a challenge. In this study, we designed a device for testing the circulation of the expanded flap that can decrease the risk of expanded flap necrosis, thus maximizing the use of an expanded flap.MethodsA total of 128 patients who underwent surgical repair between 2011 and 2019 and were retrospectively examined with the device for testing the circulation of the expanded flap were included in the study. The procedure included (1) making a device for testing the circulation, (2) implanting a skin expander, (3) injecting normal saline into the skin expander, (4) testing the circulation of the expanded flap, and (5) transferring the expanded flap to repair the defect.ResultsOne hundred forty-eight expanded flaps were implanted in 128 patients. The expanded flap that was transferred to repair the defect had no necrosis or infection. None of the expanded flaps with separated blood supply, which could be observed during operations, revealed complications. The survival rates of the expanded flap were increased by testing the circulation of the expanded flap. Expanded flaps designed by this method showed no swelling or paleness and no obvious temperature changes. In addition, the length-to-width ratio could be extended to 3:1.ConclusionsOur proposed method resulted in an effective surgical procedure for the repair of tissue defects. This approach could effectively change the direction of the blood vessel of the expanded skin flap and prevent necrosis of the expanded flap, thus representing a practical way to increase the use of expanded flaps and the flap survival rate, making the whole expanded flap transfer procedure more convenient.

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Section: Discussionmentioning

confidence: 99%

Testing the circulation of expanded flaps—prevention of necrosis of expanded flaps (a clinic study)

Han

Chen

et al. 2023

Front. Pediatr.

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“…The nasal area is anatomically complex, for its comprehensive reconstruction an integral understanding is necessary, this being a three-dimensional structure with its bone and cartilaginous support, a mucous lining and a skin covering, and according to the condition of these structures it is the surgical and reconstructive challenge to face. The general principles of reconstruction are also applicable to the nasal area as long as we understand and respect the nasal units and subunits [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of Nasal Subunits using a Nasolabial Flap: Case Report

Montufar¹,

Va²,

Cb³

2021

J Surg Open Access

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“…Many methods, such as full-thickness skin grafting, local or free flap, and expanded flap, have been used to reface the defect of lower part of the face and neck. [1][2][3] The cervical area is considered as the best donor site for the face reconstruction. But with scar contracture or tumor invasion, cervical area might be compromised and no longer available.…”

mentioning

confidence: 99%

“…Patients’ appearance and function can be severely undermined due to these injuries or lesions. Many methods, such as full-thickness skin grafting, local or free flap, and expanded flap, have been used to reface the defect of lower part of the face and neck 1–3 . The cervical area is considered as the best donor site for the face reconstruction.…”

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confidence: 99%

“Zipper” Concept for Designing Expanded Forehead Flap in Facial-Cervical Reconstruction

Chen

Tian

2021

Journal of Craniofacial Surgery

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Background: Skin defect of the lower part of the face and neck is a severe condition for many patients with burn and traumatic injuries or skin lesions. The expanded forehead flap with anterofrontal temporal vessel pedicles has been widely used in lower cheeks, chin, and neck reconstruction. (In this study, we introduce a new concept-''Zipper concept'' of the flap design.) The aim of this study is to evaluate the feasibility and outcome of using expanded forehead flap with a vertical incision with or without a small transverse incision in the central part. Methods: From March 2010 to September 2016, 27 patients who suffered from lower cheeks and chin skin defects were reconstructed by expanded forehead flap with anterofrontal temporal vessel pedicles. After the lesion was excised, the upper or the lower part of the flap was cut in half with a vertical incision with or without a small transverse incision in the middle part as needed for cheeks, upper lip or neck reconstruction, and the other part of the flap was remained to be one piece for chin reconstruction. Results: All flaps survived completely without any congestion or necrosis. All patients achieved satisfactory results both functionally and aesthetically. Conclusions: A vertical incision with or without a small transverse incision in the central part of the expanded forehead flap with anterofrontal temporal vessel pedicles is a safe modification of the flap design. It is practical and could bring the expanded forehead flap to more indications.

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Reconstruction of Skin Defects on the Mid and Lower Face Using Expanded Flap in the Neck

Abstract: The application of expanded flaps in the neck is proved to be an effective way of repairing facial defects on the mid and lower face. The technique is remarkably reliable in resurfacing the peripheral facial esthetic units.

Cited by 9 publications

References 9 publications

Testing the circulation of expanded flaps—prevention of necrosis of expanded flaps (a clinic study)

Testing the circulation of expanded flaps—prevention of necrosis of expanded flaps (a clinic study)

Reconstruction of Nasal Subunits using a Nasolabial Flap: Case Report

“Zipper” Concept for Designing Expanded Forehead Flap in Facial-Cervical Reconstruction

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