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Engineered Vascularized Muscle Flap
Published on: January 11, 2016
Sizeable Facial and Cervical Defect Repair using a Medial Arm Flap Combined With the Tissue Expansion Technique:
1The Second Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background:
The aim of this study was to present the 15-year clinical results using a preexpanded pedicle medial arm flap for repairing massive facial and cervical defects.
Methods:
The process of our method is divided into 3 stages. In the first stage, the rectangle-shaped tissue expander was implanted subcutaneously in the medial arm region and serially inflated for ~3 months. In the second stage, the distal portion of the flap was to cover the defects, the proximal portion was overlapped with the residual lesion flap. The pedicle was divided 3 weeks later, and the extra tissue was reinserted back to the donor site.
Results:
A total of 27 patients were retained. All donor sites were closed directly. Maximum and minimum sizes of preexpanded cervical flaps were 2015 cm2 to 5.54 cm2. In 2 cases, partial necrosis occurred at the distal end of the flap, while the remaining flap survived completely. The median duration of follow-up was 7.5 years. During follow-up, 24 patients (88.9%) had satisfactory outcomes and 3 patients (11.1%) had partially satisfactory results.
Conclusion:
Using expanded pedicle medial arm flap for face or neck defects' reconstruction showed that it was safe and effective, and had satisfying results in the long-term follow-up. The flap based on the proximal pedicle has a more reliable blood supply.
