[Repair of cervicofacial scar by forehead expansive skin flap double-pedicled with superficial temporal vessels].
OBJECTIVE
To explore the clinical efficacy of using forehead expansive skin flap double-pedicled with superficial temporal vessels for repairing male cervicofacial scar.


METHODS
From July 2005 to June 2009, 13 male patients with an average age of 27 years old (range: 21 - 38) were operated by the above method. The scar-repairing area was from 14 cm × 5 cm to 32 cm × 15 cm. The procedure was carried out in three stages. Firstly, ultrasound Doppler was used to detect and mark the location and orientation of superficial temporal artery. A proper cavity was created under the forehead muscle and then the appropriate expander embedded through the scalp incision. The expander was expanded first by injecting normal saline at 1 or 2 weeks post-operation. After that, the injection was repeated by 3 or 5 days. The volume ratio of injection to expander was (1.5-3.5):1. Secondly the forehead expansive skin flap was designed with proper hair follicle scalp pedicled by bilateral superficial temporal artery when the expansion was completed. After removal of the expander, the rectangle expansive skin flap with hair follicle scalp was transferred through the double pedicle. The cervicofacial scar was excised according to the size of the transferred expansive skin flap (25 cm × 6 cm to 32 cm × 9 cm). And the flap was adjusted with hair follicle scalp to the middle of the chin area in order to obtain the normal beard appearance. Donor site were closed directly. Thirdly, the pedicle skin flap were cut and restored after one month.


RESULTS
The volume expanded for each expander ranged from 420 to 800 ml (mean: 660). The average expansion time was 4 months (range: 3 - 5). All flaps survived well. Donor site were closed directly. Both chin and beard looked normal.


CONCLUSIONS
Repairing hypertrophic scar and reconstructing beard in cervicofacial area with forehead expansive skin flap pedicled by bilateral superficial temporal artery is a valuable and safe method. The donor site is scarless. And the reconstructed chin and beard are normal both functionally and aesthetically.
Huang
Yong-xin
YX
Department of Burns & Plastic Surgery, First Hospital Affiliated to Fuzhou General Hospital of Nanjing Military Region, Putian City, Fujian Province, Putian 351100, China.
Fan
Jin-cai
JC
Liu
Li-qiang
LQ
Zhan
Xin-hua
XH
Zheng
Jing-wei
JW
D000328:Adult; D002921:Cicatrix / Q000601:surgery*; D006801:Humans; D008297:Male; D009333:Neck / Q000601:surgery; D056948:Orthognathic Surgical Procedures; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply; D015626:Tissue Expansion