title: An algorithm for using expanded cervical flaps to resurface facial defects based on five different methods.
abstract: BACKGROUND
  For patients with healthy skin in the cervical region, the expanded cervical flap method is highly recommended for resurfacing facial skin defects. Many methods exist that use an expanded cervical flap. However, a gold standard for selecting the appropriate method for each patient is lacking. Here, we introduce 5 basic principles for how to use an expanded cervical flap and an algorithm for selecting the appropriate method.
  
  
  METHODS
  The authors reviewed the medical records for all patients treated with an expanded cervical flap to restore a facial skin lesion in Shanghai's Ninth People's Hospital between 2010 and 2015.
  
  
  RESULTS
  We summarized the 5 techniques according to different types of facial deformities: (1) an advancement of the expanded cervical flap; (2) an expanded cervical flap that is rotated toward the temporal side (the rotation pivot is located in the angle of the mandible); (3) an expanded cervical flap that is rotated toward the nasal side (the rotation pivot is located in the mentum; (4) an expanded cervical flap that is rotated cephalically along the midline toward the lower third of the face (the rotation pivot is located in the bilateral angle of the mandible); and (5) a prefabricated cervical flap that is used with superficial temporal vessels.
  
  
  CONCLUSIONS
  By using this algorithm and following five basic principles, all facial defects except for those on the nose and forehead can be resurfaced using an expanded cervical skin flap.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China.
authors.forename: Bowen
authors.initials: B
authors.lastname: Gao
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China.
authors.forename: Kaiyan
authors.initials: K
authors.lastname: Xiao
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China.
authors.forename: Hainan
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China.
authors.forename: Lingling
authors.initials: L
authors.lastname: Sheng
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China.
authors.forename: Qingxiong
authors.initials: Q
authors.lastname: Yu
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China.
authors.forename: Xiyuan
authors.initials: X
authors.lastname: Mao
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China. Electronic address: drliqingfeng@yahoo.cn.
authors.forename: Qingfeng
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China. Electronic address: xiefenghe@163.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Xie
mesh_terms: D000328:Adult; D000465:Algorithms; D002056:Burns / Q000601:surgery*; D002648:Child; D005151:Facial Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009333:Neck; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D015626:Tissue Expansion / Q000379:methods*; D015625:Tissue Expansion Devices
keywords: Advancement of the expanded cervical flap; Facial skin defects; Rotation of the expanded cervical flap; Superficial temporal vessels