Reconstruction of Complex Facial Defects Using Cervical Expanded Flap Prefabricated by Temporoparietal Fascia Flap.
Reconstruction of complex facial defects using cervical expanded flap prefabricated by temporoparietal fascia flap.


BACKGROUND
Complex facial defects are required to restore not only function but also aesthetic appearance, so it is vital challenge for plastic surgeons. Skin grafts and traditional flap transfer cannot meet the reconstructive requirements of color and texture with recipient. The purpose of this sturdy is to create an expanded prefabricated temporoparietal fascia flap to repair complex facial defects.


METHODS
Two patients suffered severe burns on the face underwent complex facial resurfacing with prefabricated cervical flap. The vasculature of prefabricated flap, including the superficial temporal vessel and surrounding fascia, was used as the vascular carrier. The temporoparietal fascia flap was sutured underneath the cervical subcutaneous tissue, and expansion was begun in postoperative 1 week. After 4 to 6 months of expansion, the expander was removed, facial scars were excised, and cervical prefabricated flap was elevated and transferred to repair the complex facial defects.


RESULTS
Two complex facial defects were repaired successfully by prefabricated temporoparietal fascia flap, and prefabricated flaps survived completely. On account of donor site's skin was thinner and expanded too fast, 1 expanded skin flap was rupture during expansion, but necrosis was not occurred after the 2nd operation. Venous congestion was observed in 1 patient, but after dressing, flap necrosis was not happened. Donor site was closed primarily. Postoperative follow-up 6 months, the color, texture of prefabricated flap was well-matched with facial skin.


CONCLUSIONS
This method of expanded prefabricated flap may provide a reliable solution to the complex facial resurfacing.
Plastic Surgery Hospital, Peking Union Medical College, Beijing, China.
Ling
L
Zhang
Qinghua
Q
Yang
Haiyue
H
Jiang
Ge
G
Liu
Wanlu
W
Huang
Weiwei
W
Dong
D002056:Burns / Q000601:surgery*; D002058:Burns, Electric / Q000601:surgery; D002648:Child; D017439:Cicatrix, Hypertrophic / Q000601:surgery; D005151:Facial Injuries / Q000601:surgery*; D005205:Fascia / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D006940:Hyperemia / Q000209:etiology; D008297:Male; D009333:Neck / Q000601:surgery; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods; D040521:Subcutaneous Tissue / Q000601:surgery; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation*; D013699:Temporal Arteries / Q000637:transplantation; D015626:Tissue Expansion / Q000379:methods*; D015625:Tissue Expansion Devices; D055815:Young Adult