Severe scar deformities of the face and neck after burns have a great impact on the quality of life of patients; their treatment, too, is one of the difficult problems that burn plastic surgeons focus on.
Skin grafting is a classic plastic surgery solution and is still a very important measure; however, the degree of scar growth and contracture is often greater after thin skin grafting; thick skin grafting also has the problem of scar growth and contracture afterwards, and the problem of difficulty in controlling the local skin color after the survival of the grafted skin.
The invention and clinical use of soft tissue expanders has given new blood to this treatment; it has been introduced to China for more than 20 years and has brought benefits to a large number of patients. However, in most cases, the local application of flap expansion is limited due to the limited expansion ratio of the expander and the limited aspect ratio required for flap survival; at the same time, for one thing, the damage to the neck and face of such patients is often extensive, and the remaining normal skin is already very limited; for another, especially in the neck, the local deep layer is soft soft tissue and lacks hard support, so the expansion efficiency of the expander is not high. These, to a certain extent, limit the use of local expansion flaps.
In recent years, with the deepening and popularization of research and clinical application of penetrating arterial flap, for patients with more normal skin residue in the neck and shoulder, upper chest, forehead and even back, attempts have been made to repair patients with severe scar deformities of the face and neck with penetrating arterial flap (pre-expansion or non-expansion). The donor area can often be directly sutured, and considerable clinical results have been achieved.
The advancement and development of clinical work is naturally very beneficial to improve the prognosis and quality of life of patients with indications; it is also naturally very encouraging and motivating to the clinicians themselves – however, seemingly simple words and seemingly simple work require the joint efforts of a strong team, the precipitation and accumulation of years of clinical experience, and a lot of meticulous and complicated pre- and postoperative work. It requires a lot of detailed and complicated pre and post work – the good thing is, these attempts and choices are finally successful and gradually mature; patients with indications can finally have more suitable choices, and can finally get better clinical results!