Free medial thigh perforator flap for reconstruction of the dynamic and static complex burn scar contracture.
BACKGROUND
Dynamic and static complex scar contractures after burn commonly cause tendon adhesion, deep adipose tissue stiffness and further limitation of major joints motion. Skin autografting or locoregional flaps are not adequate reconstructive options, because of the easy recurrence and limitation of donor sites. Therefore, free perforator flaps are playing increasing role in reconstruction of complex scar contractures.


METHODS
The free medial thigh perforator (MTP) flap is an addition to the reconstructive armamentarium and is particularly useful since the medial thigh is commonly spared in burn injury. Between December 2001 and October 2005, eight patients with severe post-burn scar contractures received free MTP flaps treatment in the Linkou Burn Center. The free MTP flap harvest was modified to enhance its reliability and versatility. Flap sizes ranged from 5 x 15 cm to 8 x 24 cm. The follow-up period was from 12 to 26 months. Flap harvest is rapid, averaging 37.8 min.


RESULTS
The significantly improved range of motion of the contracture joints approximated to normal activity at 6-22-month follow-up (p<0.05). No free major MTP flap complication was noted, except for mild marginal necrosis in one case.


CONCLUSIONS
The free MTP flap with new modified harvest is a good choice for dynamic an static complex scar contractures of major joints, due to short harvesting time and few variations of the pedicle. However, thick skin paddle was considered in secondary hand reconstruction.
Feng
Chung-Ho
CH
Department of Plastic and Reconstruction Surgery, Chang Gung Memorial Hospital, Chang Gung Medical Collage, Chang Gung University, Taoyuan, Taiwan.
Yang
Jui-Yung
JY
Chuang
Shiow-Shuh
SS
Huang
Chun-Yuan
CY
Hsiao
Yen-Chang
YC
Lai
Chao-Yi
CY
D000328:Adult; D002056:Burns / Q000150:complications* / Q000601:surgery; D002921:Cicatrix / Q000601:surgery*; D003286:Contracture / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D013848:Thigh / Q000601:surgery; D016896:Treatment Outcome