Use of a Bipedicled Thin Groin Flap in Reconstruction of Postburn Anterior Neck Contracture

Matsumine, Hajime; Sakurai, Hiroyuki; Nakajima, Yoshikazu; Kubo, Kazuyuki; Higuchi, Ryouhei; Nozaki, Motohiro

doi:10.1097/prs.0b013e318180ed43

Cited by 12 publications

(6 citation statements)

References 8 publications

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“…Free flaps such as groin flap [ 5 ], ALT [ 8 ], and scapular skin flaps [ 6 , 18 ] have been reported for reconstruction of cervical contractures. A large free flap could resurface large defect, but at the cost of high donor site morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of severe contracture is always challenging for the reconstructive surgeon [ 1 , 2 ]. Although various surgical techniques have been described [ 3 , 4 , 5 , 6 ], no definitive consensus was formed to guide the treatment. Upon the choice of tissue type for covering the wound after release of cervical contracture, should skin graft or skin flap be used?…”

Section: Introductionmentioning

confidence: 99%

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Region-Oriented and Staged Treatment Strategy in Reconstruction of Severe Cervical Contracture

et al. 2015

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IntroductionSevere cervical contracture after burns causes obvious impairment of neck movement and the aesthetic silhouette. Although various surgical techniques for treatment have been described, there is not a definitive strategy to guide treatment. Over the past 6 years, we have been utilizing a region-oriented and staged treatment strategy to guide reconstruction of severe cervical contracture. Satisfactory results have been achieved with this strategy.MethodsThe first stage of treatment focuses on the anterior cervical region and submental region. Procedures include cicatrix resection, contracture release, division and elevation of the platysma to form two platysma flaps, and skin grafting. Three to six months later, the second stage treatment is performed, which localize to the mental region. This includes scar resection, correction of the lower lip eversion, and reconstruction with free (para)scapular skin flap. Three subtypes of cervicomental angle that we proposed were measured as quantitative tool for evaluation of the reconstruction.Results24 patients who completed the treatment were reviewed. By the 3rd postoperative month, their CM angles changed significantly: the soft tissue CM angle was reduced from 135.0° ± 17.3° to 111.1° ± 11.3°, the osseous CM angle increased from 67.1° ± 9.0° to 90.5° ± 11.6° and the dynamic CM angle increased from 21.9° ± 8.7° to 67.4° ± 13.1°. 22 in 24 (91.7%) of these patients gained notable improvement of cervical motion and aesthetic contour.ConclusionsOur results suggest that the region-oriented and staged treatment strategy can achieve satisfactory functional and aesthetic results, combining usage of both skin graft and skin flap while minimizing the donor site morbidity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Region-Oriented and Staged Treatment Strategy in Reconstruction of Severe Cervical Contracture

et al. 2015

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“…Many different surgeries have been described for the repair of neck defects. Most commonly used techniques are full/split thickness skin grafting, Z-Plasties, local flaps and free flaps 2,3 . Recently, perforator flaps and their combinations have been frequently used for reconstruction of large skin-soft tissue defects.…”

Section: Introductionmentioning

confidence: 99%

Boyun defektlerinin preekspanse oksipito-serviko-dorsal ada flepleri ile onarımı

Eser¹,

Olguner²,

Sabancıoğularından³

et al. 2016

Cukurova Medical Journal (Çukurova Üniversitesi Tıp Fakültesi Dergisi)

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ÖzPurpose: Neck defects usually occur after burn contracture release and benign or malignant neck tumor excisions. Frequently used neck skin reconstruction methods are skin grafting, Z-Plasties, skin pedicled or perforator flaps, and free flaps. Pre-expanded perforator skin flaps are useful options for skin defect reconstructions. Pre-expansion of the skin flap provides more tissue for the reconstruction and donor area closure. Additionally, defect reconstructions used by adjacent skin maintain a good tissue colour and texture match with the defect. Material and Methods: In this study, 8 patients (neck burn contracture release (n=7) and congenital giant hairy nevus excision (n=1)) whose neck defects were reconstructed with 11 pre-expanded occipito-cervicodorsal perforator island flaps were evaluated. The maximum and minimum flap sizes were 9x23 cm and 5x13 cm respectively. Mean age of the patients was 15.8 and mean expansion time was 11.5 weeks. Results: Mean follow-up time was 27.8 months. We encountered an expander exposition in one case and 50% flap necrosis in another case. Aesthetic and functional improvement was observed in all patients. Conclusion: The pre-expanded occipito-cervico-dorsal perforator island flap is useful in moderate sized lateral neck defects. The aforementioned flap provides good tissue compliance and colour with neck and minimal donor area morbidity. It is a new useful reconstructive method in patients with lateral neck defects, who have a healthy cervico-dorsal skin and do not have useful ventral skin. Amaç: Boyun cildi defektleri genellikle kontraktür sebestleştirilmesi veya malign/benign tümör eksizyonu sonrası meydana gelir. Sık kullanılan boyun cilt rekonstrüksiyon yöntemleri Z-plastiler, cilt pediküllü veya perforatör flepler ve serbest fleplerdir. Bunlara ek olarak son zamanlarda pre-ekspanse perforator cilt flepleri cilt defekt rekonstrüksiyonlarında sıkça kullanılmaktadır. Cilt fleplerinin ekspansiyonu rekonstrüksiyon ve donor alan onarımı için daha fazla doku sağlar. Ayrıca defektlerin yakın doku ile rekonstrüksiyonu, renk ve yapı uyumu açısından iyi sonuçlar verir. Gereç ve Yöntem: Bu çalışmada 7'si boyun kontraktür açılması sonrası ve 1'i konjenital dev kıllı nevus eksizyonu olmak üzere boyunda cilt defekti olan 8 hasta değerlendirildi. Tüm defektlere toplam 11 adet preekspanse oksipito-serviko-dorsal ada flebi ile onarım uygulandı. En geniş flep boyutu 9x23 cm iken en küçük flep boyutu 5x13 cm idi. Ortalama hasta yaşı 15.8 idi ve ortalama ekspansiyon zamanı 11.5 hafta idi. Bulgular: Hastalar ortalama 27,8 ay takip edildi. bir hastada doku genişletici ekspozisyonu oluşurken başka bir hastada %50 flep nekrozu görüldü. Tüm hastalarda estetik ve fonksiyonel sonuçlar kabul edilebilir seviyelerdeydi. Sonuç: Preekspanse oksipito-serviko-dorsal flep, orta büyüklükteki boyun defektlerinde kullanılabilecek uygun bir rekonstrüksiyon seçeneğidir. Tanımlanan flep, özellikle ön servikal ve torakal cildi uygun olmayan ve dorsal serviko-dorsal cildi sağlam olan hastalarda uygulanabilecek ye...

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“…It can be used as either a pedicle or free flap and is a good choice for reconstruction in the extremities, [3][4][5][6][7] perineum, 8,9 trunk, 10,11 head, and neck. [12][13][14] The shortcomings of the groin flap include bulkiness, variations in the vascular anatomy, and a small, short pedicle. In this study, we present a new methodology of flap design and harvest according to the anatomic characteristics of the groin flap and its successful clinical application in 35 patients.…”

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confidence: 99%

Freestyle Groin Flaps

Chao

Tsai

Wang

et al. 2015

Annals of Plastic Surgery

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Use of a Bipedicled Thin Groin Flap in Reconstruction of Postburn Anterior Neck Contracture

Cited by 12 publications

References 8 publications

Region-Oriented and Staged Treatment Strategy in Reconstruction of Severe Cervical Contracture

Region-Oriented and Staged Treatment Strategy in Reconstruction of Severe Cervical Contracture

Boyun defektlerinin preekspanse oksipito-serviko-dorsal ada flepleri ile onarımı

Freestyle Groin Flaps

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