Split Ascending Neck Flap in Burned Face Resurfacing

Abstract

Postburn face and neck deformities, contractures, and large nevi are very traumatic cosmetic defects for patients and present serious problems for surgeons. Much attention is therefore paid to the development of the most effective reconstructive techniques. The problem is especially pressing in cases of total or extensive deformities (more than half of the cheek plus neck damage). The skin of the neck matches the skin of the cheeks better than any other transplant, but its displacement is restricted by platysma. During mobilization of the cervical flaps, axial vessels are frequently injured, leading to tissue necrosis. We overcame these obstacles by locating and preserving the vascular bundle of the skin of the anterior neck surface. Tissue expansion may be used for making neck flaps larger; however, a high rate of complications restricts extensive use of expanders. Various flaps are moved or rotated from neighboring and distant regions, and free tissue transfer has been used. However, differences in skin quality is a serious cosmetic disadvantage of these flaps.