Abstract:

Objective　To explore the application of sequential expanded flap in reconstruction of severe burn scars.

Methods　Using the principle of“sequential”

skin flap, the adjacent area of the skin flap donor site was expanded, and the

tissue generated by the second expansion flap was used to cover the defect left by the first expansion flap. This technique was

applied to repair large area of extensive adhesions between the chin and neck using dorsal scapular flap. The main flap was an

axial flap with a dual blood supply from the ascending scapular artery and the superficial cervical artery. After soft tissue expan

sion, a large skin flap was formed, and the skin on the shoulder carrying the superficial cervical artery perforator was used as the

pedicle to rotate the flap to the anterior chest and neck to repair extensive scars of adhesions between the chin and neck/chest.

The expansion device for the relay flap was implanted in the lower back of the main flap, and the defect in the scapular area was

repaired by rotating the spiral propeller flap with perforator or random flap. Results　A total of 12 patients were included in this

study, 9 males and 3 females, aged 5-45 years (mean 24.7 years), all with extensive scars and contractures of the neck and chest

after burns. The size of the scapular expansion device ranged from 300-800 mL, and the size of the sequential expansion device

in the lower back ranged from 80-300 mL. The area of the scapular expansion flap ranged from 430-840 cm2 , and 1-4 intercos

tal perforators were found near the sequential expansion flap in the lower back (mean 2.3 perforators), usually used to rotate the