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A new method: perforator-based tissue expansion for a preexpanded free cutaneous perforator flap
1Department of Plastic Surgery, LinKou Burn Center, Chang Gung Memorial Hospital, 5 Fu-Hsin St., Kweishan, Taoyuan, Taiwan. plastysai@hotmail.com
Burns : Journal of the International Society for Burn Injuries
|November 26, 2003
Summary
This study introduces a novel prefabrication technique using tissue expansion for large burn contractures. The method successfully resurfaced a severe neck burn, significantly improving patient mobility and function.
Area of Science:
- Reconstructive surgery
- Tissue engineering
- Burn management
Background:
- Large postburn contractures pose significant reconstructive challenges.
- Free anterolateral thigh (ALT) flaps offer reliable anatomy for reconstruction.
- Pre-expansion techniques can enhance flap size for extensive defects.
Observation:
- A novel technique combining pre-expansion, perforator-based tissue expansion, and a free ALT flap was developed.
- This approach was applied to a patient with a large postburn cervical contracture (45% total body surface area).
- The procedure involved tissue expander insertion, serial expansion, flap harvesting, and reconstruction.
Findings:
- The preexpanded free ALT flap (29cm x 15cm) successfully resurfaced the cervical contracture defect.
- The flap achieved total survival with immediate postoperative functional improvement.
- Six months post-surgery, rotation increased by 14 degrees and lateral flexion by 10 degrees.
Implications:
- Perforator-based tissue expansion offers safe and accurate flap expansion for burn reconstruction.
- This technique enables the use of larger free flaps for extensive burn defects.
- The method provides a viable option for improving function and aesthetics in severe burn contractures.