Bipedicled Expanded Cervical Postauricular Combined Flap or Bipedicled Expanded Cervical Flap for Facial Reconstruction

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Abstract

Background:

Large facial reconstruction is a complicated surgical procedure. The purpose of this study was to develop 2 procedures for large facial reconstruction: an expanded cervical postauricular combined skin flap and a bipedicled expanded cervical skin flap.

Methods:

Two patients with large facial nevus lesions were selected for reconstruction. In 1 case, an expanded cervical postauricular combined flap with a bipedicle was designed; the upper pedicle was based at the temple region, the lower pedicle was based at the neck. In another case, an expanded cervical-only flap with a bipedicle was designed; the lower pedicle was based at the neck and the upper pedicle was based on healthy facial skin and a nevus lesion skin. All donor sites were closed simultaneously. Both patients underwent a second operation to cut the upper pedicle and repair the facial defect that resulted from the nevus lesion excision, using healthy skin to form a skin flap. The authors also formed a free skin graft from the scalp portion of the tubed pedicle to repair the facial defect where the flap could not reach.

Results:

Both patients were treated successfully. All flaps survived, without infection or necrosis. Scarring was minimal and the aesthetic and functional outcomes were good.

Conclusion:

This technique provides a large source of skin, proximal to the lesion, as well as good blood supply, especially to the distal end of the flap. It is a safe and reliable alternative for the treatment of large facial nevus lesions.

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