Repair Of Faciocervical Defect With Double Blood Supply Expanded Skin Flap From Thoracic Region

Various methods have been applied in repairing large facial or cervical soft tissue defects.In the reconstruction,not only functions are required,appearance are equally important.The demands are commendably satisfied by the combination of skin expansion and the technique of skin flap.Compared with traditional ways, complications have been reduced,and the technique has been used more frequently in clinical practice.Thoracic flaps always play an important role in the repairing of facial or cervical soft tissue defects,for its adjacent position,and can well match with their peripheral tissues.In recent years,we have used the technique of expanded double blood supply pectoral skin flap in the repairing of large facial or cervical soft tissue detects.With its increasingly perfected clinical practice,it has become a mature reconstruction technique.This thesis is composed of two parts:review of documents and clinical practice.Review of documents summarizes the development and clinical practice of pre-dilated axial-pattern flap in the repairing of large facial or cervical soft tissue defects.Summarize studies of the changes of angioarchitecture,blood supply, histology,metabolism and biomechanics of the flap during the expansion.The application of different pre-dilated axial-pattern flaps has been discussed.Thoracic skin flap has been improved by using the double blood supply thoracic pre-dilated skin flap,which is provided by both cervical cutaneous branch of transverse cervical artery and cutaneous branch of thoracoacromial artery.Since the year 2000,we have used double blood supply thoracic pre-dilated skin flap in 20 cases of large facial or cervical soft tissue defects.There were 100% survivals in 19 cases,distal skin necrosis in lcase.The results were satisfied.It is concluded that double blood supply thoracic pre-dilated skin flap is an ideal technique in repairing large facial or cervical soft tissue defects.The patients got an aesthetic look and good function without damaging the natural neck contour and donor site abnormality was avoided.