Bilateral pre-expanded supraclavicular artery flap: a versatile solution for extensive faciocervical burn contractures.

BACKGROUND

Extensive postburn face and neck contractures, particularly extending bilaterally or to the chest, pose significant reconstructive challenges. This study aims to assess the efficacy and strategies of bilateral pre-expanded supraclavicular artery flaps (SCFs) in addressing these complex defects.

METHODS

A retrospective study was conducted at our institution from January 1, 2015, to January 1, 2024, encompassing patients who underwent bilateral pre-expanded SCF reconstruction for faciocervical scar contractures. Data on patient demographics, flap characteristics, and postoperative outcomes were collected.

RESULTS

Twenty-one patients (median age, 11 years) underwent reconstruction with 42 pre-expanded SCFs. Indications included bilateral faciocervical scars (n = 7), full-neck scars (n = 5), and combined face, neck, and chest scars (n = 9). All flaps survived completely, with dimensions ranging from 8 cm × 5 cm to 25 cm × 13 cm. At a mean follow-up of 5.85 years, 95.2% of patients (20/21) reported satisfaction with the appearance and texture of the flaps, and all demonstrated improved neck mobility. Complications occurred in 19.0% of flaps (one wound dehiscence, three distal venous congestions), all of which resolved with conservative management.

CONCLUSION

Bilateral pre-expanded SCFs provide a reliable option for reconstructing extensive faciocervical contractures, including bilateral cervicofacial involvement, entire neck involvement, or with mentosternal adhesions, achieving both aesthetic and functional improvements.