Use of free thin anterolateral thigh flaps combined with cervicoplasty for reconstruction of postburn anterior cervical contractures.

Abstract

Free thin anterolateral thigh flaps combined with cervicoplasty were used in a series of seven patients undergoing reconstruction for previous burn injury from September of 2000 to May of 2001 at Chang Gung Memorial Hospital. This method uses a suprafascial dissection technique to provide a thin flap to improve cervical contour. Neck contractures had resulted from flame burns in six patients and from a chemical burn in one patient. The mean age was 32.7 years (range, 22 to 45 years). The size of excised scar ranged from 10 x 2 cm to 26 x 5 cm (mean, 19.7 x 3.3 cm). The size of flaps ranged from 11 x 5 cm to 26 x 8 cm (mean, 21.3 x 6.5 cm). Average operative time was 6 hours. Average hospital stay was 10 days. All flaps survived, with one flap sustaining partial marginal loss. The donor site was closed primarily in five cases and by using a split-thickness skin graft in two cases. At a mean follow-up time of 5 months, the functional improvement was measured as follows: a mean increase in extension of 30 degrees (preoperatively, 95 degrees; postoperatively, 125 degrees), a mean increase in rotation of 18 degrees (preoperatively, 59 degrees; postoperatively, 77 degrees), and a mean increase in lateral flexion of 12.5 degrees (preoperatively, 26.5 degrees; postoperatively, 39 degrees). The average cervicomandibular angle was improved by 25 degrees (preoperatively, 145 degrees; postoperatively, 120 degrees). This series demonstrates that the use of free thin anterolateral thigh flaps combined with cervicoplasty provides a one-stage reconstruction with a thin, pliable flap that achieves good cervical contour with low donor-site morbidity.

• Authors: Jui-Yung Yang, Feng-Chou Tsai, Jagdeep S Chana, Shiow-Shuh Chuang, Sung-Yuan Chang, Wei-Chao Huang
• Journal: Plastic and reconstructive surgery (Plast Reconstr Surg) Vol. 110 Issue 1 Pg. 39-46 (Jul 2002) ISSN: 0032-1052 [Print] United States
• PMID: 12087229 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Burns (surgery)
• Burns, Chemical (surgery)
• Contracture (surgery)
• Female
• Follow-Up Studies
• Humans
• Male
• Microsurgery
• Middle Aged
• Neck Injuries (surgery)
• Surgical Flaps (blood supply)
• Taiwan
• Thigh (blood supply, surgery)
• Wound Healing (physiology)