Aesthetic and functional restoration of anterior neck scar contracture using a bipedicled expanded forehead flap.

Abstract

The study aimed to explore a new method to restore functional and cosmetic outcomes for anterior neck burn scar contracture. Tissue expanders were implanted subcutaneously under the muscle of the forehead. Tissue expansion started 1 week postoperatively. When the skin expansion finished, a bilateral pedicled expanded skin flap was created on the basis of the superficial temporal artery and transferred to the anterior neck. Both the range of motion of cervical spine and the mental cervical angle were measured before and after operation. Data were analysed by Statistical Package for Social Sciences (SPSS) 13.0 and t-test. From September 2006 to May 2010, six male patients were treated by this method. The active range of motion of the neck of patients improved, the postoperative ranges of active flexion, extension, left flexion, right flexion and left and right rotation of cervical spine increased respectively. The mental cervical angle was 152.7±1.9° preoperatively and 90.7±2.2° postoperatively; the physiological angle was recovered. Patients were followed up from 5 months to 3 years, they were satisfied with the results and no recurrence of contracture was found. The bipedicled expanded forehead flap, which provided good blood supply, repaired anterior contracture in the neck and created both aesthetic and functional results; it also diminished donor morbidity.