Eur J Plast Surg (2001) 24:221 DOI 10.1007/s002380100257 INVITED COMMENTAR Y S. Hovius “Reconstruction of extensive postburn scar deformities and contractures of the neck using expanded and nonexpanded tissue transfer,” Moroz et al. Published online: 12 June 2001 © Springer-Verlag 2001 The authors should be congratulated on their article on troublesome, and the full aesthetic unit of the neck is the reconstruction of postburn scar contractures of the neck underestimated. using expanded and nonexpanded free tissue transfers. In Argrigiani , not mentioned in the article, has a total of 63 patients, they used 55 “scapular” flaps, of beautifully described the correction of postburn neck which 30 were pre-expanded and 25 were not. In the contracture. First of all, the aesthetic unit of the neck text, they state that vascular problems occurred in 10 out (from the border of the mandible to the sternal notch, of 63 flaps, in which three successful anastomoses were and laterally to an imaginary line from the earlobe to the achieved. In Table 3, eight vascular complications were middle of the clavicle) is mostly not appreciated enough documented. What happened to these patients (more than in the lateral region. Hypertrophic scars are therefore 10%)? Did they receive new flaps? induced at the borders in burned areas lateral to the flap In their discussion, no differences are noted between inset. The flap should be designed for the full neck unit, pre-expanded and nonexpanded flaps. In 19% of the covering about 28×18 cm in the male and 26×16 cm in patients, the chin/neck angle was defatted. In addition, the female. It should be larger in the middle and 4 cm hypertrophic and keloid scars on the borders of less at the sides. transplanted flaps are described without monitoring the Secondly, pre-expanded flaps are rather thick and percentage or number of cases. These corrections were can look unnatural. Thirdly, two to three incisions are made 3 months following flap surgery. In my experience, necessary to correct the chin/neck angle, to defat the flap especially in growing children, the chin/neck angle is and to correct the borders. One can argue about the too large, the hypertrophic scars at the edges can be timing, which is up to three times within 30 days, as proposed by Argrigiani. This commentary refers to the paper at http://dx.doi.org/10.1007/ s002380100256. References S. Hovius ( ) University Hospital Dijkzigt, Department of Plastic and Reconstructive Surgery, 1. Argrigiani C (1994) Aesthetic microsurgical reconstruction of P.O. Box 2040, 3000 CA Rotterdam, The Netherlands anterior neck burn deformities. Plast Reconstr Surg 93(3): e-mail: email@example.com 507–518
European Journal of Plastic Surgery – Springer Journals
Published: Jun 12, 2001
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