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Reconstruction of post-burn anterior neck contractures using a butterfly design free anterolateral thigh perforator flap

Archives of Plastic Surgery 2020년 47권 2호 p.194 ~ 197
Lellouch Alexandre G., Pozzo Victor, Suffee Tabrez, Lantieri Laurent A.,
소속 상세정보
 ( Lellouch Alexandre G. ) - Paris Descartes University European Georges Pompidou Hospital Department of Plastic Reconstructive Surgery
 ( Pozzo Victor ) - Paris Descartes University European Georges Pompidou Hospital Department of Plastic Reconstructive Surgery
 ( Suffee Tabrez ) - Paris Descartes University European Georges Pompidou Hospital Department of Plastic Reconstructive Surgery
 ( Lantieri Laurent A. ) - Paris Descartes University European Georges Pompidou Hospital Department of Plastic Reconstructive Surgery

Abstract


Anterior neck burns represent a major reconstructive challenge due to severe sequalae including restriction in movement and poor aesthetic outcomes. Common treatment options include skin grafting with/without dermal matrices, and loco-regional and distant free flap transfers with/without prior tissue expansion. Such variation in technique is largely influenced by the extent of burn injury requiring resurfacing. In order to optimize like-for-like reconstruction of the anterior neck, use of wide, thin and long flaps such as the anterolateral thigh (ALT) perforator flap have been reported with promising results. Of note, some patients have a tendency towards severe scar contractures, which may be contributed by the greater extent of inflammation during wound healing. We report our experience at 4 years’ follow-up after secondary reconstruction of severe, anterior neck burn contractures in two patients by harvesting the ALT flap with a butterfly design. This technique provides adequate wound resurfacing of the burned neck and surrounding areas, and provides good neck extensibility by addressing both anterior and lateral aspects of the scar defect simultaneously. Such a flap design reduces tension on wound edges and thus, the risk of contracture recurrence in what remains a particularly challenging type of burn reconstruction.

키워드

Free flap; Neck; Reconstructive surgical procedures; Burns; Contracture

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