Application of pre-expanded scalp flap in reconstruction of faciocervical defects

DING Jianke; TANG Yinke; CHU Feifei; LIU Shiqiang; MA Xianjie

doi:10.13276/j.issn.2097-1656.2024.08.010

Abstract：Objective To investigate the effect of pre-expanded scalp flaps in repairing faciocervical defects.Methods From January 2012 to October 2023,50 patients with faciocervical defects were treated with pre-expanded scalp flaps in the Department of Plastic Surgery,Xijing Hospital,Air Force Medical University.In stage one,appropriate tissue expander was implanted under galea aponeurotica and injected regularly according to the location and size of the lesion.In stage two,the expanded scalp was transferred to repair facial lesions.Forehead lesions were repaired by advancement scalp flap;based on unilateral superficial temporal artery,cheek and tempus lesions were repaired by expanded tempus scalp and the mentum lesions were repaired by expanded scalp flap based on bilateral superficial temporal artery.In stage three,the pedicle was cut off 3 weeks later if necessary.Laser hair removal was performed 2 weeks after removing the suture.The complications were counted and the surgical results were recorded.Results There were 50 cases in this study,including 22 forehead lesions,18 cheek and tempus lesions and 10 mentum lesions.One case of hematoma and 1 case of infection occurred in stage one,and 3 cases of dysvascularization occurred in stage two after scalp flap transfer.The area of expanded scalp flaps ranged from 5 cm × 5 cm to 12 cm × 30 cm.The color and texture of the transferred flap were close to the recipient area after 2 to 30 months of follow up,and there was no obvious scar and deformity in the donor site.Conclusion Pre-expanded scalp flap can provide skin tissue similar to the color and texture of faciocervical skin,and it is a promising procedure in reconstruction of faciocervical defects.