Application Of Platysma Myocutaneous Advanced Flap In The Repairing Of Soft Tissue Defects In Head And Face Area

Objective:To explore the feasibility and effectiveness of the platysma myocutaneous advanced flap on repairing soft tissue defects of head and face,and provide a reference for clinical application.Methods:Eight patients(4 males and 4 femals)who underwent resection surgery for soft tissue lesions in head and face area at the First Affiliated Hospital of Kunming Medical University from November 2016 to December 2020 were selected in this clinical retrospective study.All the partients were performed platysma myocutaneous advanced flap operation to repair soft tissue defects.The average age of patients were 51.5 years old,the oldest one was 77 years old and the youngest one was 20 years old.Among them,5 cases were with squamous cell carcinoma,2 cases were with basal cell carcinoma,and 1 case was with facial scar.The distribution of lesion sites were temporal region(2 cases),cheek region(4 cases),ear region(3 cases)and mandible region(1 case),respectively.The lowest lesion site was located in bilateral mandible region,and the highest lesion site was located in 3cm above eyebrow tail of frontal region.The lesions were removed completely from all the patients.According to the location and size of the soft tissue defects,the platysma myocutaneous advanced flaps were designed and transfered to repair these defects.The minimum intraoperative defect area was 6.0*4.0cm and the maximum defect area was 10.0*9.0cm.After 7 to 10 days closely postoperative observation and regularly changing dressing,the sutures was removed.The survival of the flaps were investigated through outpatient reviewing and telephone follow-up,the investigation contents included with or without scar hyperplasia,obvious traction and displacement of head and facial organs,deformity,dysfunction,as well as the satisfaction of patients and the family members.Results:Through outpatient reviews and telephone follow-up surveys,6 patients were with platysma myocutaneous advanced flap completely survived,1 patients was with wound unhealing,and 1 patient was lost follow-up.No obvious scar hyperplasia,traction and displacement of head and facial organs,deformity and dysfunction were observed postoperation.The rates for general satistaction with repairing were 100%.Conclusion:Higher survival rate,large repairable area,low complication rate and high satisfaction of patients and their families make the platysma myocutaneous advanced flap as an potential useful reconstruction surgury for head and face soft tissue defects.