Retrospective Analysis Of Transverse Cervical Artery Perforator Flap Repairing Wound In Face And Neck

Objective:To observe the clinical effect of transverse cervical artery perforator flaps repairing scar or radiation ulcer in face and neck.Methods:Retrospective analysis of 15 cases of transverse cervical artery perforator flaps(or expanded flaps)which were applied in Guangzhou Red Cross Hospital from September 2017 to December 2019.According to the position of the perforator,15 cases of flaps were divided into cervical group and dorsal group.According to whether inserted expander,flaps were divided expanded group and unexpanded group.The scar or radiation ulcer area,the flap area,the flap thickness,the operation time,bleeding volume were recorded.Date were processed with t test.Results:(1)The comparison between the cervical group and the dorsal group:among the 15 flaps,there were 8 cases of cervical perforator flap,7 cases of dorsal perforator flap.The scar or radiation ulcer area was 134.00±52.27 cm~2in cervical group and 115.14±38.76 cm~2in dorsal group,and there was no significant difference between the two groups(P>0.05).The flap area was 136.00±51.26 cm~2in the cervical group and 133.00±43.85 cm~2in the dorsal group.there was no significant difference between the two groups(P>0.05).Furthermore,there was no significant difference between the two groups in operation time and bleeding volume(P>0.05).The flap thickness in the cervical group(4.33±0.88 mm)was less than that in the dorsal group(6.79±0.99 mm)(P<0.05).(2)The comparison between the expanded group and the unexpanded group:among the 15 cases,there were 8 cases in the expanded group,7 cases in the unexpanded group.The scar or radiation ulcer area in the expanded group(153.88±33.19 cm~2)was larger than that in the unexpanded group(92.43±35.74 cm~2)(P<0.05).The flap area in the expanded group(163.38±35.23 cm~2)was larger than that in the unexpanded group(99.43±33.46 cm~2)(P<0.05).The flap thickness in the expanded group(4.48±1.06 mm)was less than that in the unexpanded group(7.00±0.96 mm)(P<0.05).There was no significant difference in operation time between the two groups(P>0.05).(3)Among the 15 flaps,1 case had skin necrosis about the size of 3 cm×2 cm at the distal end of the flap,which was repaired with skin grafting.The other 14 flaps survived completely.The donor site was suture primary,except 1 case of 3 cm×3 cm size was covered by moderate thickness skin grafting.All of them had been followed up for 3～12 months with satisfactory appearance and sensation.93.3%patients were satisfied with appearance and sensation.Conclusion:The flap thickness of cervical perforator is thinner than that of dorsal perforator in transverse cervical artery flap.The expanded transverse cervical artery perforator flap is thin,large,satisfactory appearance and sensation.It is one of ideal choices for repairing wound of face and neck.