[Combined scapular/parascapular bilobar flaps for reconstruction of severe neck contracture].
OBJECTIVE
To discuss the reconstruction of severe neck contracture by transplanting combined scapular/parascapular bilobar flaps, and the probability to reestablish three-dimensional movement of the neck.


METHODS
From January 2003 to November 2004, 9 cases of sustained severe neck contractures were treated (aged 9-32 years). The combined scapular/parascapular bilobar flaps, pedicled on the circumflex scapular vascular bundle, were microsurgically used to cover the soft tissue defect after excision of hypertrophic scar and release of contracture. The maximum size of the combined bilobar flap was 20 cm x 8 cm to 20 cm x 11 cm, while the minimum one was 15 cm x 4 cm to 15 cm x 6 cm.


RESULTS
The combined scapular/parascapular flaps were successfully used to treat 9 cases of severe neck contracture. All patients were satisfied with the final functional and aesthetic results. There was no recurrence during 3-9 months follow-up for 8 patients. The cervicomental angle was 90-105 degrees.


CONCLUSIONS
The combined bilobar scapular/parascapular flap, providing a large area of tissue for coverage in three dimensions with a reliable blood supply by only one pedicle anastomosis during operation, is a good option for reconstruction of the severe neck contracture.
Zhang
Yixin
Y
Department of Plastic and Reconstructive Surgery, Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, PR China.
Qian
Yunliang
Y
Wang
Danru
D
D000293:Adolescent; D000328:Adult; D002648:Child; D002921:Cicatrix / Q000601:surgery*; D003286:Contracture / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009333:Neck; D019651:Plastic Surgery Procedures / Q000379:methods*; D012540:Scapula; D016038:Skin Transplantation; D013524:Surgical Flaps / Q000098:blood supply