[Repair of face and upper limb defects with expanded delto-pectoral and abdominal perforator flaps]

To investigate the method and effectiveness of expanded delto-pectoral and abdominal perforator flaps in repairing large defects of the face and upper limb after scar excision.

Between August 2000 and February 2011, 25 patients with large scars on face and upper limb were treated. There were 14 males and 11 females with an average age of 27 years (range, 7-36 years). Scars causes were burn and scald in 25 cases with a disease duration of 6 months to 7 years (mean, 4.5 years). The hypertrophic scars located at face in 15 cases, and at upper limb and hand in 10 cases. The soft tissue expanders (300-500 mL in volume) were implanted in the delto-pectoral zone and abdominal region in one-stage operation. In two-stage operation, after scars were resected, defects (9 cm x 7 cm to 17 cm x 8 cm) were repaired with the delto-pectoral perforator flaps (17 cm x 7 cm to 20 cm x 8 cm) in 15 facial scar cases and with the deep inferior epigastric artery perforator flaps (10 cm x 9 cm to 25 cm x 14 cm) in 10 upper limb and hand scar cases. The donor sites were sutured directly.

Partial necrosis of the flaps occurred in 2 cases after operation, then the flap survived after expectant treatment. The other flaps and skin grafts survived successfully, and the incisions healed by first intention. Ten patients were followed up 6 months to 4 years. The appearance, texture, and color of the flaps were similar to those at the donor site.

It is an effective method to use the delto-pectoral perforator flap and the deep inferior epigastric artery perforator flap for repairing soft tissue defects of the face and upper limb after scar excision.