Clinical application of advancement flaps in repairing mandibular scars_West China Medical Journal

Authors：

XUE Dinglong ,  CEN Ying

1. Department of Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China;

Corresponding author：

CEN Ying, Email: cenying0141@163.com

Keywords：

Advancement flap; mandibular scar; repair; mento-cervical angle; cervico-mental angle

DOI：

10.7507/1002-0179.202204024

Video：

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Objective To explore the clinical application effects of cervical advancement flaps in repairing mandibular scars. Methods A retrospective analysis was performed on the clinical data of patients with mandibular scars admitted to the Department of Plastic and Burn Surgery of West China Hospital of Sichuan University between January 2018 and July 2020. The lateral X-ray images of the patients were analyzed before and 2 weeks after surgery, and the differences in the mento-cervical angles and the cervico-mental angles before and after surgery were compared. Results A total of 21 patients were included, including 7 males and 14 females. At admission, all patients had a mandibular scar area of (3-7) cm × (3-6) cm, and underwent primary repair with cervical advancement flaps. All patients had good postoperative skin flaps survival, primary wound healing, and obvious mento-cervical angle and cervico-mental angle. The preoperative mento-cervical angle was (110.24±9.47)°, and at 2 weeks post surgery, the mento-cervical angle was (98.39±4.95)°, with a statistically significant difference (P<0.05). The preoperative cervico-mental angle was (134.15±6.00)°, and at 2 weeks post surgery, the cervico-mental angle was (126.44±3.60)°, with a statistically significant difference (P<0.05). Conclusion The neck advancement flap is an effective surgical method for treating simple mandibular scar, which is simple and can improve the appearance of the jaw and neck.

Citation： XUE Dinglong, CEN Ying. Clinical application of advancement flaps in repairing mandibular scars. West China Medical Journal, 2024, 39(3): 468-471. doi: 10.7507/1002-0179.202204024 Copy

1.	Motamed S, Mousavizadeh SM, Niazi F, et al. Lateral lower face and neck contouring following burn injury. Acta Med Iran, 2015, 53(4): 225-230.
2.	Sinha I, Nabi M, Simko LC, et al. Head and neck burns are associated with long-term patient-reported dissatisfaction with appearance: a burn model system national database study. Burns, 2019, 45(2): 293-302.
3.	Wang BB, Patel KF, Wolfe AE, et al. Adolescents with and without head and neck burns: comparison of long-term outcomes in the burn model system national database. Burns, 2022, 48(1): 40-50.
4.	Luo X, Liu F, Wang X, et al. Region-oriented and staged treatment strategy in reconstruction of severe cervical contracture. PLoS One, 2015, 10(4): e0122669.
5.	Sabapathy SR, Shanmugakrishnan RR, Ramkumar S, et al. Postburn reconstruction of the face and neck. Plast Reconstr Surg, 2022, 150(6): 1326e-1339e.
6.	张伟, 张卫东, 陈斓, 等. 扩张皮瓣整复大面积烧伤后面颈部瘢痕挛缩畸形的临床效果. 中华烧伤与创面修复杂志, 2023, 39(9): 826-834.
7.	於国军, 封必钊, 杨卫玺, 等. 颌面部软组织缺损修复临床美学分析. 中国医药导刊, 2010, 12(11): 1858, 1860.
8.	Khalatbari B, Bakhshaeekia A. Ten-year experience in face and neck unit reconstruction using tissue expanders. Burns, 2013, 39(3): 522-527.
9.	Hu X, Zeng G, Zhou Y, et al. Reconstruction of skin defects on the mid and lower face using expanded flap in the neck. J Craniofac Surg, 2017, 28(2): e137-e141.
10.	Song Y, Li Y, Xia C, et al. Use of tissue expansion and serial Z-plasty for release of neck postburn scar contracture. J Burn Care Res, 2019, 40(6): 966-971.
11.	王占统, 董琛, 唐银科, 等. 预扩张胸三角皮瓣修复面颈部病损的临床效果. 中华烧伤杂志, 2020, 36(5): 363-369.
12.	Cao Z, Liu L, Fan J, et al. Aesthetic design of expanded bilateral superficial temporal vascular fascial pedicled flap for repairing maxillocervical scars. Ann Plast Surg, 2021, 87(5): 509-513.
13.	张家平, 袁希, 江旭品, 等. 基于“MRIS”原则采用扩张皮瓣美学整复颏颈部瘢痕挛缩畸形. 中华烧伤与创面修复杂志, 2022, 38(4): 306-312.
14.	Cao Z, Liu L, Fan J, et al. Different transfer forms of the expanded forehead flap pedicled with superficial temporal vessels to treat chin and submental scar deformities. J Craniofac Surg, 2022, 33(4): 1066-1070.
15.	Pei J, Zhang J, Li Y, et al. Restoration of lower facial and neck esthetics by application of pre-expanded bipedicle scalp and free scapular flaps. J Craniofac Surg, 2023, 34(2): e161-e164.
16.	Luo SS, Li YQ. Using an expanded cervical flap with an overlapping tissue expansion technique to resurface middle and lower facial defects. J Craniofac Surg, 2023, 34(4): 1325-1328.
17.	马显杰, 李威扬, 刘超华, 等. 面部烧伤后瘢痕的美学整复策略及疗效. 中华烧伤杂志, 2016, 32(8): 469-473.
18.	Busch LF, Alawi SA. Evaluation of patients’ preferences for skin grafting in plastic-surgical defect coverage. World J Plast Surg, 2020, 9(3): 259-266.
19.	Legemate CM, Ooms PJ, Trommel N, et al. Patient-reported scar quality of donor-sites following split-skin grafting in burn patients: long-term results of a prospective cohort study. Burns, 2021, 47(2): 315-321.
20.	Neale HW, Kurtzman LC, Goh KB, et al. Tissue expanders in the lower face and anterior neck in pediatric burn patients: limitations and pitfalls. Plast Reconstr Surg, 1993, 91(4): 624-631.
21.	Bozkurt A, Groger A, O’Dey D, et al. Retrospective analysis of tissue expansion in reconstructive burn surgery: evaluation of complication rates. Burns, 2008, 34(8): 1113-1118.
22.	魏大勇, 贺光照, 刘佳. 软组织扩张器治疗面颈部瘢痕的技术及并发症分析. 中国医疗美容, 2019, 9(11): 128-133.
23.	何小川, 吴国平, 廖毅, 等. 颈部瘢痕挛缩整复术中颌颈角形成的技巧与美学意义. 中国美容医学, 2009, 18(7): 914-916.

1. Motamed S, Mousavizadeh SM, Niazi F, et al. Lateral lower face and neck contouring following burn injury. Acta Med Iran, 2015, 53(4): 225-230.
2. Sinha I, Nabi M, Simko LC, et al. Head and neck burns are associated with long-term patient-reported dissatisfaction with appearance: a burn model system national database study. Burns, 2019, 45(2): 293-302.
3. Wang BB, Patel KF, Wolfe AE, et al. Adolescents with and without head and neck burns: comparison of long-term outcomes in the burn model system national database. Burns, 2022, 48(1): 40-50.
4. Luo X, Liu F, Wang X, et al. Region-oriented and staged treatment strategy in reconstruction of severe cervical contracture. PLoS One, 2015, 10(4): e0122669.
5. Sabapathy SR, Shanmugakrishnan RR, Ramkumar S, et al. Postburn reconstruction of the face and neck. Plast Reconstr Surg, 2022, 150(6): 1326e-1339e.
6. 张伟, 张卫东, 陈斓, 等. 扩张皮瓣整复大面积烧伤后面颈部瘢痕挛缩畸形的临床效果. 中华烧伤与创面修复杂志, 2023, 39(9): 826-834.
7. 於国军, 封必钊, 杨卫玺, 等. 颌面部软组织缺损修复临床美学分析. 中国医药导刊, 2010, 12(11): 1858, 1860.
8. Khalatbari B, Bakhshaeekia A. Ten-year experience in face and neck unit reconstruction using tissue expanders. Burns, 2013, 39(3): 522-527.
9. Hu X, Zeng G, Zhou Y, et al. Reconstruction of skin defects on the mid and lower face using expanded flap in the neck. J Craniofac Surg, 2017, 28(2): e137-e141.
10. Song Y, Li Y, Xia C, et al. Use of tissue expansion and serial Z-plasty for release of neck postburn scar contracture. J Burn Care Res, 2019, 40(6): 966-971.
11. 王占统, 董琛, 唐银科, 等. 预扩张胸三角皮瓣修复面颈部病损的临床效果. 中华烧伤杂志, 2020, 36(5): 363-369.
12. Cao Z, Liu L, Fan J, et al. Aesthetic design of expanded bilateral superficial temporal vascular fascial pedicled flap for repairing maxillocervical scars. Ann Plast Surg, 2021, 87(5): 509-513.
13. 张家平, 袁希, 江旭品, 等. 基于“MRIS”原则采用扩张皮瓣美学整复颏颈部瘢痕挛缩畸形. 中华烧伤与创面修复杂志, 2022, 38(4): 306-312.
14. Cao Z, Liu L, Fan J, et al. Different transfer forms of the expanded forehead flap pedicled with superficial temporal vessels to treat chin and submental scar deformities. J Craniofac Surg, 2022, 33(4): 1066-1070.
15. Pei J, Zhang J, Li Y, et al. Restoration of lower facial and neck esthetics by application of pre-expanded bipedicle scalp and free scapular flaps. J Craniofac Surg, 2023, 34(2): e161-e164.
16. Luo SS, Li YQ. Using an expanded cervical flap with an overlapping tissue expansion technique to resurface middle and lower facial defects. J Craniofac Surg, 2023, 34(4): 1325-1328.
17. 马显杰, 李威扬, 刘超华, 等. 面部烧伤后瘢痕的美学整复策略及疗效. 中华烧伤杂志, 2016, 32(8): 469-473.
18. Busch LF, Alawi SA. Evaluation of patients’ preferences for skin grafting in plastic-surgical defect coverage. World J Plast Surg, 2020, 9(3): 259-266.
19. Legemate CM, Ooms PJ, Trommel N, et al. Patient-reported scar quality of donor-sites following split-skin grafting in burn patients: long-term results of a prospective cohort study. Burns, 2021, 47(2): 315-321.
20. Neale HW, Kurtzman LC, Goh KB, et al. Tissue expanders in the lower face and anterior neck in pediatric burn patients: limitations and pitfalls. Plast Reconstr Surg, 1993, 91(4): 624-631.
21. Bozkurt A, Groger A, O’Dey D, et al. Retrospective analysis of tissue expansion in reconstructive burn surgery: evaluation of complication rates. Burns, 2008, 34(8): 1113-1118.
22. 魏大勇, 贺光照, 刘佳. 软组织扩张器治疗面颈部瘢痕的技术及并发症分析. 中国医疗美容, 2019, 9(11): 128-133.
23. 何小川, 吴国平, 廖毅, 等. 颈部瘢痕挛缩整复术中颌颈角形成的技巧与美学意义. 中国美容医学, 2009, 18(7): 914-916.

West China Medical Journal

Clinical application of advancement flaps in repairing mandibular scars

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