Expanded latissimus dorsi free flap for the treatment of extensive post-burn neck contracture

An expanded latissimus dorsi flap (expanded LD flap) was transferred in two patients with severe post-burn neck contracture. Free flaps created using standard techniques are of limited size and sometimes cannot cover the defect after excision of scar tissue, particularly when a severe burn scar extends to the facial region. However, the authors found in their cases that the expanded LD flap could cover the whole anterior neck and face. The flap was sufficiently reduced in thickness so that revisional operations required for debulking were limited to the area around the pedicles. It is suggested that tissue expansion prior to free flap transfer is useful for enlargement of the flap survival area and thinning of the flap.