[Repair of the facial defects using the expanded induced prefabricated skin flap of the retroauricular and mastoid process region based on the superficial temporal vascular bundle].
OBJECTIVE
To provide an ideal method for flap prefabrication.


METHODS
The superficial temporal fascial flap has been elevated based on the superficial temporal vessels during the first-stage procedure. A subcutaneous tissue pocket with appropriate site was formed in the retroauricular and mastoid process region. The fascial flap was transferred into the pocket and fixed properly. The tissue expander was placed under the fascial flap. When the expanding process has been finished, the expander was removed and the expanded induced prefabricated skin flap of the retroauricular and mastoid process region pedicled on the superficial temporal vascular bundle was elevated and transferred to repair the facial skin defect.


RESULTS
There were nine cases in the group. Facial defects after resection of the melanotic nevus was repaired in 2 cases and facial defects after resection of the facial haemangioma and scar were repaired in 2 and 5 cases respectively. Pedicle length of the superficial temporal fascial flap was ranged from 5.5 cm to 7 cm (mean length 6.2 cm). The size of the fascial flaps was ranged from 4 cm x 3 cm to 7 cm x 7 cm (mean size 5.7 cm x 4.9 cm). The size of the prefabricated skin flaps was ranged from 5 cm x 5 cm to 8.0 cm x 7.5 cm (mean size 6.4 cm x 6.1 cm). The average time of the tissue expansion process is 16.1 weeks. All flaps survived postoperatively and the donor sites of the flaps were appropriated directly in 5 cases. The split-thickness skin grafting was used to recover the donor site defects in 4 cases.


CONCLUSIONS
The superficial temporal fascial flap owns the following advantages: the vascular pedicle is much longer and vascular supply is plentiful, and it is convenient to transfer. Meanwhile, the skin of the retroauricular and mastoid process region is most similar to that of the face in texture, color and depth. For the patients selected strictly, the technique mentioned above is somewhat an ideal method for facial defect repair.
Liu
Yuan-Bo
YB
Plastic Surgery Hospital, Chinese Academy of Medical Science, Beijing 100041, China.
Fan
Jin-Cai
JC
Jiao
Peng
P
Tang
Xin
X
Liu
Li-Qiang
LQ
Wang
Qian
Q
Tian
Jia
J
Gan
Cheng
C
Yang
Zeng-Jie
ZJ
Zhang
Zhuo-Nan
ZN
Chen
Yu-Gang
YG
D000293:Adolescent; D000328:Adult; D002648:Child; D004431:Ear, External / Q000601:surgery*; D005151:Facial Injuries / Q000601:surgery*; D005205:Fascia / Q000637:transplantation; D005260:Female; D006801:Humans; D008297:Male; D016038:Skin Transplantation / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps; D015626:Tissue Expansion; D016896:Treatment Outcome; D055815:Young Adult