title: Reconstruction of large unilateral hemi-facial scar contractures with supercharged expanded forehead flaps based on the anterofrontal superficial temporal vessels.
abstract: BACKGROUND
  The expanded forehead flap, using temporal pedicles, has been employed extensively in facial reconstruction. To overcome the disadvantages of the traditional dual temporal pedicles, such as the limited transfer range and the short length of the flap, the distal supercharging technique can be applied to lengthen the flap and extend the transfer range, especially in the cases with a past temporal burn injury. This article aims to present an application of the distal supercharged expanded forehead flap procedure for hemi-facial reconstruction and discuss the haemodynamics of the expanded forehead flap.
  
  
  METHODS
  The tissue expander implantation and the following forehead tissue expansion were performed regularly. When the forehead skin expansion was completed, an expanded forehead flap was created and transferred to the damaged facial area with one distal temporal vessel pedicle that was anastomosed with facial vessels in a supercharged way. All patients were analysed retrospectively.
  
  
  RESULTS
  From September 2009 to September 2011, eight male patients and one female patient were treated using this method. Their flaps size ranged from 20 cm × 8 cm to 30 cm × 11 cm and no flap loss occurred. Patients came in for follow-ups 9-16 months after the procedures. All the patients were satisfied with the results.
  
  
  CONCLUSIONS
  The supercharging expanded forehead flap procedure can provide reliable flap vascularity due to its elastic transferring abilities. By using a distal supercharging technique, we can lengthen and widen the flap to tailor it to the defect, while also minimising the donor defect in the patients with a past temporal injury.
authors.affiliation: The Ninth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Badachu Road 33#, Beijing 100144, People's Republic of China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Gan
authors.forename: Jincai
authors.initials: J
authors.lastname: Fan
authors.forename: Liqiang
authors.initials: L
authors.lastname: Liu
authors.forename: Jia
authors.initials: J
authors.lastname: Tian
authors.forename: Hu
authors.initials: H
authors.lastname: Jiao
authors.forename: Wenlin
authors.initials: W
authors.lastname: Chen
authors.forename: Siqi
authors.initials: S
authors.lastname: Fu
authors.forename: Suyun
authors.initials: S
authors.lastname: Feng
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000150:complications; D002648:Child; D002921:Cicatrix / Q000209:etiology / Q000601:surgery*; D005145:Face / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005546:Forehead / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply* / Q000502:physiology; D015626:Tissue Expansion; D055815:Young Adult
keywords: Facial and cervical reconstruction; Forehead flap; Microsurgery; Tissue expansion