Application of the expanded lateral thoracic pedicle flap in face and neck reconstruction.

Abstract

Massive scars of face and neck cause severe esthetic and functional problems in patients. To achieve better outcomes, in this study, we demonstrate the use of the expanded lateral thoracic pedicle flap, which provides a large and thin flap that matches the face and neck area in color and texture with minimal donor site morbidities. Firstly, a tissue expander was embedded in the lateral thoracic region. After water inflation, the expanded lateral thoracic flap was elevated as a pedicle flap and was then transferred to replace scar tissue of the head and neck. Doppler ultrasound examinations were employed pre-operatively to identify the path of the nutrient arteries of the flap. A surgical delay procedure was performed two weeks prior to flap transfer. Ten patients were treated with this method. For 9 patients, the outcomes were satisfactory and were not characterized by obvious flap contraction after 3-17 months of follow-up. The final patient sustained flap necrosis in the distal one-third of the flap. The donor sites were primarily closed in 80% of the cases. The expanded lateral thoracic pedicle flap proved to be a reliable method with satisfactory outcomes for skin reconstruction of the face and neck.