Supraclavicular bilobed fasciocutaneous flap for postburn cervical contractures

Ortiz, C. Laredo; Carrasco, Alfonso; Torres, Ashley Novo; Sempere, Laura; Mendoza, Mario

doi:10.1016/j.burns.2006.10.395

Cited by 22 publications

(5 citation statements)

References 12 publications

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“…Z-plasties, split-thickness skin grafts, and full-thickness skin grafts often heal with retraction and contractures. Local flaps, if they are available, can be bulky, cover only limited areas, and may necessitate revision surgery [28,29]. Because skin grafts a sufficient amount of dermis, skin dermis substituents were a good alternative.…”

Section: Discussionmentioning

confidence: 99%

The Use of Collagen-Glycosaminoglycan Biodegradable Matrix (Integra®) in the Management of Neck Postburn Hypertrophic Scars and Contractures

Hoinoiu

Grujic

Prilipceanu³

et al. 2020

Applied Sciences

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Glycosaminoglycan (GAG) is a chain-like disaccharide that is linked to a polypeptide core to connect two collagen fibrils/fibers and provide the intermolecular force in a Collagen-GAG matrix which can be a valuable treatment of post-burn contractures and hypertrophic scars, which remain a challenge to reconstructive surgery. The face and neck contractures are the most difficult sites to treat. This article is meant to discuss our clinical experience in using collagen-glycosaminoglycan biodegradable matrix (Integra® Integra Lifesciences Corporation, Plainsboro, NJ, USA) to reconstruct defects created by excision of contracted areas from the neck and lower face areas. Between 2009 and 2011, we had 11 patients that underwent Integra reconstructive procedures. The mean follow-up period was 18 months. For all the patients, the intake of the Integra dermal regeneration template was 100%, even if one patient developed a minor infection treated with appropriate antibiotics. The patients are very satisfied with the result. A minor problem was a small difference in skin color, but this inconvenience was compensated by good skin elasticity.

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Section: Discussionmentioning

confidence: 99%

The Use of Collagen-Glycosaminoglycan Biodegradable Matrix (Integra®) in the Management of Neck Postburn Hypertrophic Scars and Contractures

Hoinoiu

Grujic

Prilipceanu³

et al. 2020

Applied Sciences

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“…In this setting, the supraclavicular flap, with its higher pivot point and longer pedicle, can overcome such limitations; in fact, since the first published study about this flap in 1979, hundreds of patients have undergone reconstructive surgery with a SIF, making it a well‐established surgical procedure . However, it has been reported that the SIF is limited in width . Conversely, in our opinion, the subclavicular TBSA pedicled flap has demonstrated to overcome the disadvantages of a limited flap width in comparison to the supraclavicular flap, and in addition, it has shown many advantages that other pedicled cervical flaps, such as the submental flap and the infrahyoid flap, do not.…”

Section: Discussionmentioning

confidence: 94%

Subclavicular flap: A valid reconstructive option among anterior chest flaps in oral cancer patients

Mannelli

Agostini

Arcuri

et al. 2019

Journal of Surgical Oncology

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Background: The subclavicular pedicled flap is based on the thoracic branch of the supraclavicular artery, and it represents a versatile reconstructive option for lowmiddle third face defects. Since its use in head and neck surgical oncology has not been popularized yet, we propose its application for oral cavity reconstruction after cancer resection by showing favorable results.Methods: Eighteen subclavicular pedicled flaps were used to treat intraoral defects after oral squamous-cell cancer resection between June 2015 and December 2018.Tumor dissection type, complications, donor and reconstructed area results, and functional and aesthetic outcomes were assessed. Results: No major complications were observed and all of the flaps survived. Adjuvant therapy was administered without delay when needed, and all of the patients had normal functional outcomes and good aesthetic results. Conclusions: The subclavicular flap is an excellent choice for the reconstruction of oral cavity defects. Selection of patients should exclude positive lower-third neck node and include appropriate informed consent for women due to the possibility of deformity of the breast. In our opinion, this flap has the potential for common application given its consistent anatomy and donor site advantages, including long pedicle, high pivot point, and relatively unlimited flap width. K E Y W O R D S oral cancer, pedicled flap, reconstruction, thoracic branch of supraclavicular artery 1 | INTRODUCTION Deformed appearance and impaired function in the oral cavity due to tumor resection necessitate appropriate and high-quality reconstructive tissue. Among multiple reconstructive options, microsurgical techniques might be time-consuming and costly, and the results are not always satisfactory, even though free flaps remain the first choice for vessel-depleted neck and osseous reconstruction, as well as for through-and-through defects. 1 Consequently, the adjacent pedicled local flaps (eg pectoralis major, submental island, and deltopectoral flaps) are excellent alternative reconstructive options due to their fair color and contour, even though they are usually bulky. In this setting, the chest region seems to be an ideal donor site, with abundant vessel networks that can guarantee a high reconstructive success rate 2-4 and where, depending on the skin paddle design, differing skin thicknesses are available. In many people, the skin is not hair-bearing and the color match is ideal for cervicofacial skin. Various flaps have been explored, 5 including muscle-sparing thoracoacromial artery perforator flaps, 6 propeller flaps, 7 and supraclavicular flaps, 8 but the short length of the pedicle, the long distance Meeting: This paper was presented as oral presentation at the 24th Congress of the European Association for Cranio Maxillo Facial Surgery, 18 to 21 September 2018, in Munich, Germany.

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“…21 As facial scars are seen in the most exposed region of the body, these are easily seen and can cause much embarrassment to the patient. 22 Facial structures such as the nose and teeth may be deformed by post-burn contractures. There are certain serious complications such as occlusion amblyopia and microstomia must be anticipated and urgently addressed to reverse the permanent consequences.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Facial burn in children: a review

Swain

2023

Int J Contemp Pediatr

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Burns are a common cause of injury among children. Children with facial burns often experience pain, regardless of the cause, size, or depth of the burn injury. Burns in the facial area may lead to fatal consequences because of the involvement of the upper airway and cosmetic deformity of the face. Major burn injury in the facial area remains a significant cause of morbidity and mortality in children. Burn scars on the face in children may disturb the self-image and psychosocial processes. Multi-disciplinary approaches and advances in burn care are often helpful to manage the burn injury in children and increase the survival of the patients. Pain has adverse emotional and physiological impacts, and adequate pain control is an important factor in improving outcomes. The goal of the treatment of facial burns in children is to achieve a good aesthetic outcome and also normal head movement with neck mobilization.

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Supraclavicular bilobed fasciocutaneous flap for postburn cervical contractures

Cited by 22 publications

References 12 publications

The Use of Collagen-Glycosaminoglycan Biodegradable Matrix (Integra®) in the Management of Neck Postburn Hypertrophic Scars and Contractures

The Use of Collagen-Glycosaminoglycan Biodegradable Matrix (Integra®) in the Management of Neck Postburn Hypertrophic Scars and Contractures

Subclavicular flap: A valid reconstructive option among anterior chest flaps in oral cancer patients

Facial burn in children: a review

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