title: Pre-expanded cervico-acromial fasciocutaneous flap based on the supraclavicular artery for resurfacing post-burn neck scar contractures.
abstract: OBJECTIVE
  Post-burn cicatricle contractures of neck pose a challenge for plastic and reconstructive surgeons. To improve functional and cosmetic results, and to minimize the donor-site morbidity, we use pre-expanded cervico-acromial fasciocutaneous flap based on the supraclavicular artery as a feasible choice for resurfacing large skin defects of the neck.
  
  
  METHODS
  In this series, from 2008 to 2012, 18 patients with ages ranging between 11 and 42 years (20 flaps with 2 patients in bilateral fashion) suffering from post-burn scar contractures of the neck were treated. In the first stage, an expander was implanted on the deep fascia layer of the cervico-acromial region; 600 to 800 mL of saline was then injected during a 10- to 16-week period. In the second stage after expansion, sufficient skin and tissue was obtained to resurface the defects of the neck after releasing the contractures and excision of post-burn scars.
  
  
  RESULTS
  All 20 flaps healed primarily with good functional and cosmetic results. The maximum size was 23×16 cm, whereas the minimum was 20×8 cm. After an average follow-up time of 12 months, significant improvement in range of motion with good esthetic outcomes were achieved, and the scars in donor sites seemed acceptable. There ware no significant complications.
  
  
  CONCLUSIONS
  The pre-expanded cervico-acromial fasciocutaneous flap based on the supraclavicular artery can provide a large amount of thin tissue with both good color and texture, and without the need for microsurgery, and avoid the disadvantages of donor-site morbidity. This flap is reliable and safe for resurfacing large skin defects of the neck.
authors.affiliation: From the 2nd Department of Plastic Surgery, Plastic Surgery Hospital of Peking Union Medical College and The Chinese Academy of Medical Science, Beijing, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Yang
authors.forename: Chunmei
authors.initials: C
authors.lastname: Hu
authors.forename: Yangqun
authors.initials: Y
authors.lastname: Li
authors.forename: Yong
authors.initials: Y
authors.lastname: Tang
authors.forename: Muxin
authors.initials: M
authors.lastname: Zhao
authors.forename: Wen
authors.initials: W
authors.lastname: Chen
authors.forename: Lisi
authors.initials: L
authors.lastname: Xu
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000174:Acromion; D000293:Adolescent; D000328:Adult; D001158:Arteries; D002056:Burns / Q000150:complications / Q000601:surgery*; D002648:Child; D002921:Cicatrix / Q000150:complications / Q000601:surgery*; D002968:Clavicle; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D005205:Fascia / Q000637:transplantation; D005260:Female; D006801:Humans; D008297:Male; D019838:Neck Injuries / Q000209:etiology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D016038:Skin Transplantation; D013524:Surgical Flaps / Q000098:blood supply; D015626:Tissue Expansion; D055815:Young Adult