Expanded Lateral Neck Flap Combining With Posterior Auricular Flap For Facial Skin Defect

Objective:To explore the blood supply of expanded lateral neck flap combining with posterior auricular flap pedicled on anterior neck and the feasibility of this kind of flap for facial vulnus’ resurfacingMethod:Reconstructing facial skin defect by using expanded lateral neck and posterior auricular unit flap in clinic.At the first stage of the treatment,one rectangular expander was implanted in lateral neck in the subcutaneous pockets,overlying the platysma,the volume of the expander is about 200-600 ml.After 2-3 months inflation,the pre-expanded flap called expanded lateral neck flap combining with posterior auricular flap pedicled on anterior neck was advanced,then at the second stage of the operation,the surgeons rotated the flap to lateral face to resurface the vulnus located on anterior auricle,the incision caused by operation was immediately suturedResults:A series of 12 cases with facial wounds had received implantation in this research from January 2009 to November 2016,in which all the cases are unilateral,and the largest pre-expanded flap the surgeons used,was 15cm in width and 7cm in length while the smallest one was 6cm in width and 12cm in length.According to 2 to 24 months follow-up postoperatively,10 months in average,two flaps showed venous retardation at distal part of expanded flaps,but they were both healed with one-week dress changing after excoriation.Other ten flaps in this research survived with good appearance and function.The flaps matched well to the surrounding skin in terms of color,character and elasticity.The appearance and function of face and neck were both ideally adjusted after treatmentConclusion:It is possible to obtain large expanded flaps which are near to facial skin with high quality and make maximum use of blood supply in the anterior neck at the same time by expanding lateral neck skin overlying platysma,forming the expanded lateral neck flap combining with posterior auricular flap pedicled on anterior neck,which guarantees appearance and function of both the donor area and the repair area...