J Reconstr Microsurg 2002; 18(5): 373-378
DOI: 10.1055/s-2002-33018
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Expanded Latissimus Dorsi Free Flap for the Treatment of Extensive Post-Burn Neck Contracture

Akihiko Takushima, Kiyonori Harii, Hirotaka Asato
  • Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
Further Information

Publication History

Publication Date:
31 July 2002 (online)

ABSTRACT

An expanded latissimus dorsi flap (expanded LD flap) was transferred in two patients with severe post-burn neck contracture. Free flaps created using standard techniques are of limited size and sometimes cannot cover the defect after excision of scar tissue, particularly when a severe burn scar extends to the facial region. However, the authors found in their cases that the expanded LD flap could cover the whole anterior neck and face. The flap was sufficiently reduced in thickness so that revisional operations required for debulking were limited to the area around the pedicles. It is suggested that tissue expansion prior to free flap transfer is useful for enlargement of the flap survival area and thinning of the flap.

REFERENCES

  • 1 Cronin T D. Deformities of the cervical region. In: McCarthy JG, ed. Plastic Surgery Philadelphia: WB Saunders; 1990
  • 2 Harii K, Omori K, Omori S. Successful clinical transfer of ten free flaps by microvascular anastomoses.  Plast Reconstr Surg . 1974;  53 259
  • 3 Harii K, Ohmori K, Ohmori S. Utilization of free composite tissue transfer by microvascular anastomoses for the repair of burn deformities.  Burns . 1975;  1 237
  • 4 Hallock G G. Free flap donor site refinement using tissue expansion.  Ann Plast Surg . 1988;  20 566
  • 5 Laitung J K, Batchelor A G. Successful preexpansion of a free scapular flap.  Ann Plast Surg . 1990;  25 205
  • 6 Cronin T D. The use of a molded splint to prevent contracture after split-thickness skin grafting on the neck.  Plast Reconstr Surg . 1961;  27 7
  • 7 Willis B. A follow-up: the use of orthoplast isoprene splints in the treatment of the acutely burned child.  Am J Occup Ther . 1970;  24 187
  • 8 Ohkubo E, Kobayashi S, Sekiguchi J. Restoration of the anterior neck surface in the burned patient by free groin flap.  Plast Reconstr Surg . 1991;  87 276
  • 9 Harii K, Yamada A, Ishihara K. A free transfer of both latissimus dorsi and serratus anterior flaps with thoracodorsal vessel anastomoses.  Plast Reconstr Surg . 1982;  70 620
  • 10 Thoma A, Heddle S. The extended free scapular flap.  Br J Plast Surg . 1990;  43 709
  • 11 Xu J, Li S K, Li Y Q. Superior extension of the parascapular free flap for cervical burn scar contracture.  Plast Reconstr Surg . 1995;  96 58
  • 12 Leighton W D, Russell R C, Marcus D E. Experimental pretransfer expansion of free-flap donor sites. I.  Plast Reconstr Surg . 1988;  82 69
  • 13 Leighton W D, Russell R C, Feller A M. Experimental pretransfer expansion of free-flap donor sites. II.  Plast Reconstr Surg . 1988;  82 76
  • 14 Cherry G W, Austad E, Pasyk K. Increased survival and vascularity of random-pattern skin flaps elevated in controlled, expanded skin.  Plast Reconstr Surg . 1983;  72 680
  • 15 Mayou B J, Gault D T, Crock J G. Tissue expanded free flaps.  Br J Plast Surg . 1992;  45 413
  • 16 Hoffman W Y, Barton R M, Vasconez L O. Latissimus dorsi musculocutaneous flap to the head, neck, cheek, and scalp. In: Strauch B, Vasconez LO, Hall-Findlay EJ, eds. Encyclopedia of Flaps Boston: Little, Brown; 1990
  • 17 Celikoz B, Sengezer M, Guler M M. Reconstruction of anterior neck contractures with sensate expanded radial forearm free flap.  Burns . 1996;  22 320
  • 18 DeHaan M R, Hammond D C, Mann R J. Controlled tissue expansion of a groin flap for upper extremity reconstruction.  Plast Reconstr Surg . 1990;  86 979