title: Pre-expanded thoracodorsal artery perforator-based flaps for repair of severe scarring in cervicofacial regions.
abstract: BACKGROUND
  Reconstruction of cervicofacial scarring continues to present challenges for surgical treatment. Here we present our clinical experience in repairing cervicofacial scarring using pre-expanded thoracodorsal artery perforator flaps.
  
  
  METHODS
  From January 2007 to December 2012, 15 patients were treated for severe cervicofacial scarring. In the first surgical stage, expanders were implanted subcutaneously in the zone nourished by thoracodorsal artery perforators. The expansion generally took 3 to 6 months. In the second surgical stage, the cervicofacial cicatricial contracture was released and the secondary defect was covered with local flaps. The remaining wound was covered by the free thoracodorsal artery perforator expanded flap, which was anastomosed to the facial vascular bundle. The donor site was closed directly in all the patients.
  
  
  RESULTS
  The postoperative follow-up time ranged from 1 to 5 years. The deformities were corrected, all flaps survived completely and none were bulky. The maximum length of the flaps was 32 cm (mean, 22.4 ± 4.2 cm), and the maximum width was 17 cm (mean, 14.4 ± 2.2 cm). All patients exhibited recovery of neck movement, and there was no recurrence of neck contracture.
  
  
  CONCLUSIONS
  The pre-expanded thoracodorsal artery perforator flap is an ideal method for reconstruction of severe cervicofacial cicatricial contracture.
authors.affiliation: Department of Burn and Plastic Surgery, Center Hospital of Hanzhong City, Hanzhong, China.
authors.forename: Ai-Wu
authors.initials: AW
authors.lastname: Wang
authors.affiliation: Department of Burn and Plastic Surgery, Center Hospital of Hanzhong City, Hanzhong, China.
authors.forename: Wan-Feng
authors.initials: WF
authors.lastname: Zhang
authors.affiliation: Department of Burn and Plastic Surgery, Center Hospital of Hanzhong City, Hanzhong, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Liang
authors.affiliation: Department of Burn and Plastic Surgery, Center Hospital of Hanzhong City, Hanzhong, China.
authors.forename: Jin-You
authors.initials: JY
authors.lastname: Li
authors.affiliation: Department of Burn and Plastic Surgery, Center Hospital of Hanzhong City, Hanzhong, China.
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Zhang
authors.affiliation: Department of Burn and Plastic Surgery, Center Hospital of Hanzhong City, Hanzhong, China.
authors.forename: Xue-Tao
authors.initials: XT
authors.lastname: Niu
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D044964:Cervicoplasty; D002648:Child; D002921:Cicatrix / Q000601:surgery*; D003286:Contracture / Q000517:prevention & control*; D005151:Facial Injuries / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D061525:Perforator Flap / Q000098:blood supply*; D016038:Skin Transplantation; D013997:Time Factors; D015626:Tissue Expansion; D016896:Treatment Outcome; D014945:Wound Healing