Đánh giá kết quả sử dụng vạt da hai cuống tự do vùng lưng điều trị sẹo di chứng bỏng rộng vùng cổ - mặt

Abstract

Background: Nowadays, face and neck reconstruction for post-burn patients, especially for large burn scars, always challenges plastic surgeons. The formerly reconstructive procedures, for instance, skin graft, local flaps, tissue expansion…have numerous disadvantages. For reconstruction of large burn scars in the face and neck region, the dorsal double-free flaps are the first choice to recover functional and cosmetic outcomes.
Patients and methods: Fifteen patients, 10 females and 5 males, were admitted at the Center of the Plastic, Reconstructive and Aesthetic Surgery of the National Hospital of Burn from August 2019 to August 2024. Range of age from 12 to 61 years old.
Nine dorsal double perforator free flaps with circumflex scapular artery perforator and contralateral posterior intercostal perforator, three dorsal double perforator free flaps with circumflex scapular artery perforator and ipsilateral posterior intercostal perforator two bipedicle flap with posterior intercostal perforator and ipsilateral posterior intercostal perforator and one flap with posterior intercostal perforator and contralateral posterior intercostal perforator, were designed at the dorsal region. Recipients were the facial artery and/or superficial temporal artery. The adipose tissue between the two pedicles was thinned before the pedicles divided. The pedicles of the flap were anastomosed with the recipient's vessels.
Results: Thirteen flaps survived completely and two flaps happened a distal part necrosis. The donor site was covered by using a split-thickness skin graft. The maximum length of the flaps we could obtain was 36cm, the largest width was 19cm. The patients were satisfied with both cosmetically and functionally.
Conclusion: Dorsal double pedicle free flap is a confident procedure in the reconstruction of large defects on the face and neck region post-burn patients.