title: Reconstruction of the face and neck scar contractures using staged transfer of expanded "Super-thin flaps".
abstract: BACKGROUND
  The authors introduced the "Super-thin flap" concept, which is sometimes called the subdermal vascular network (SVN) flap, in 1994. Since 1994, we have reconstructed face and neck scar contractures using various types of "Super-thin flaps." In this report, we introduce expanded "Super-thin flaps" for reconstruction of the face and neck for the first time in a patient.
  
  
  METHODS
  Since 2000 we have used 21 expanded flaps to reconstruct 21 face or neck scar cases in nine males and 12 females. In the first operation, an expander was inserted on the fascia of the pectoralis major muscle, and then about 1,000 cc of saline was injected during a 2-month period. In the second operation, the flap was thinned primarily and applied to the recipient site. Three weeks after the second operation, the pedicle of the flap was cut down and sutured.
  
  
  RESULTS
  Flap size ranged from 4 cm x 14 cm to 10 cm x 22 cm. Expanded volume ranged from 800 cc to 1,200 cc. All flaps survived completely and scar tissues were replaced with normal skin. Flaps did not shrink after the operations, and contractures did not recur.
  
  
  CONCLUSIONS
  Advantages of the expanded flaps are presented: (1) Large flaps can be harvested because of the expander; (2) Extremely thin flaps can be safely employed; (3) Texture and color match are good; (4) Donor site can be closed primarily; and (5) Microsurgery is not required. However, the disadvantage of the method is the requirement for two or three operations.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Nanfang Medical University, Guangzhou, China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Gao
authors.forename: Rei
authors.initials: R
authors.lastname: Ogawa
authors.forename: Hiko
authors.initials: H
authors.lastname: Hyakusoku
authors.forename: Feng
authors.initials: F
authors.lastname: Lu
authors.forename: Zhi-Qi
authors.initials: ZQ
authors.lastname: Hu
authors.forename: Ping
authors.initials: P
authors.lastname: Jiang
authors.forename: Ling
authors.initials: L
authors.lastname: Yang
authors.forename: Chuanbo
authors.initials: C
authors.lastname: Feng
mesh_terms: D000328:Adult; D002056:Burns / Q000601:surgery*; D002921:Cicatrix / Q000601:surgery*; D003286:Contracture / Q000601:surgery*; D005151:Facial Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D019838:Neck Injuries / Q000601:surgery*; D019651:Plastic Surgery Procedures; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps; D015626:Tissue Expansion / Q000379:methods