Bilobed fasciocutaneous flap for reconstruction of the posterior neck after necrotizing fasciitis.

Necrotizing fasciitis is an aggressive, deep-seated infection of the fascia and subcutaneous fat with necrosis of overlying skin. Eleven cases of necrotizing fasciitis of the posterior neck are reviewed to demonstrate the advantage of using a bilobed fasciocutaneous flap for repair following surgical debridement. Nine men and two women aged 40 to 65 years (mean age, 54.8 years) presented for reconstruction from April of 1999 to March of 2003. The blood supply of the bilobed fasciocutaneous flap originates from a constant row of musculocutaneous perforators of posterior intercostal arteries. The technique enabled regional reconstruction, conserved tissues, and provided satisfactory aesthetic results.