title: 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.affiliation: LinKou Burn Center, Department of Plastic Surgery, Chang Gung Memorial Hospital Taipei, 5 Fu-Hsin Street, Kweishan, Taoyuan, Taiwan. corsican@adm.egmh.org.tw
authors.forename: Jui-Yung
authors.initials: JY
authors.lastname: Yang
authors.forename: Feng-Chou
authors.initials: FC
authors.lastname: Tsai
authors.forename: Jagdeep S
authors.initials: JS
authors.lastname: Chana
authors.forename: Shiow-Shuh
authors.initials: SS
authors.lastname: Chuang
authors.forename: Sung-Yuan
authors.initials: SY
authors.lastname: Chang
authors.forename: Wei-Chao
authors.initials: WC
authors.lastname: Huang
mesh_terms: D000328:Adult; D002056:Burns / Q000601:surgery*; D002057:Burns, Chemical / Q000601:surgery; D003286:Contracture / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019838:Neck Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply; D013624:Taiwan; D013848:Thigh / Q000098:blood supply / Q000601:surgery; D014945:Wound Healing / Q000502:physiology