title: The Clinical Application of Preexpanded and Prefabricated Super-Thin Skin Perforator Flap for Reconstruction of Post-Burn Neck Contracture.
abstract: OBJECTIVE
  Based on our previous animal study, we applied the "bridging effect" to the neighboring axial flap through preexpansion and prefabrication of a skin perforator flap as a new method to reconstruct a large skin defect after release of severe neck burn scar contracture.
  
  
  METHODS
  Twelve patients suffering from severe post-burn cervical contractures underwent reconstruction of large skin defects after surgical release of severe scar contractures with preexpanded and prefabricated super-thin skin perforator flaps supplied primarily by a number of perforators via the "bridging effect" from the branches of the adjacent arteries as 2-stage procedures. During the first-stage operation, 2 tissue expanders were placed accordingly, and this was followed by a subsequent second-stage procedure where an expanded super-thin skin perforator flap was transposed to reconstruct a large neck skin defect. Follow-up was between 6 months and 3 years in this series.
  
  
  RESULTS
  All super-thin skin perforator flaps survived in this series with primary healing except one with a distal flap necrosis that was treated with a subsequent skin graft. All patients have had a good contour with improved range of motion in the neck.
  
  
  CONCLUSIONS
  The preexpansion and prefabrication of a super-thin skin perforator flap can possibly improve the anastomoses between neighboring subdermal vascular plexuses and extend the supplying area of these vessels to the flap. This method may provide a favorable super-thin skin flap that can be used for reconstruction of large neck defects after release of post-burn cervical scar contracture as demonstrated in this case series.
authors.affiliation: From the *Department of Plastic and Aesthetic Surgery, Dongguan Kanghua Hospital, Dongguan, Guangdong Province; †Department of Plastic and Cosmetic Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China; ‡Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan; and §Division of Plastic Surgery, University of California, Davis, Sacramento, CA.
authors.forename: Chunmei
authors.initials: C
authors.lastname: Wang
authors.forename: Junyi
authors.initials: J
authors.lastname: Zhang
authors.forename: Sifen
authors.initials: S
authors.lastname: Yang
authors.forename: Hiko
authors.initials: H
authors.lastname: Hyakusoku
authors.forename: Ping
authors.initials: P
authors.lastname: Song
authors.forename: Lee L Q
authors.initials: LL
authors.lastname: Pu
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000150:complications*; D002648:Child; D002921:Cicatrix / Q000209:etiology / Q000601:surgery*; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000150:complications*; D061525:Perforator Flap; D019651:Plastic Surgery Procedures / Q000379:methods*; D015626:Tissue Expansion / Q000295:instrumentation / Q000379:methods*; D015625:Tissue Expansion Devices; D016896:Treatment Outcome; D055815:Young Adult