Pre-expanded bipedicled visor flap: an ideal option for the reconstruction of upper and lower lip defects postburn in Asian males

Peiru Min , Jie Li , Beniamino Brunetti , Zheming Pu , Weijie Su , Wenjing Xi , Zheng Zhang , Rosa Salzillo , Shaoqing Feng , Yixin Zhang

Burns & Trauma ›› 2020, Vol. 8 ›› Issue (1) : tkaa005

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Burns & Trauma ›› 2020, Vol. 8 ›› Issue (1) :tkaa005 DOI: 10.1093/burnst/tkaa005
Research Article
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Pre-expanded bipedicled visor flap: an ideal option for the reconstruction of upper and lower lip defects postburn in Asian males
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Abstract

Background: Reconstruction of upper and lower lip subunits is a complicated and elusive challenge. For patients affected by defects involving upper and lower lip subunits, a technique able to reconstruct both aesthetic units with matched colour, sufficient contours and similar texture would be ideal. In this study, we present our experience with upper and lower lip reconstruction using the pre-expanded bipedicled visor flap. Methods: From January 2014 to January 2017, 12 male patients presenting with defects of the upper and lower lip subunits were treated using this surgical technique. After a period of expansion of the scalp flap of over 6 months, the bipedicled visor flap was raised from both the parietal regions and rotated to resurface the defect. Delay and section of the pedicle were then performed. Results: Twelve male patients with postburn scars aged 22 to 48 years (mean: 34 years) were successfully treated with no major complications. The donor site was closed primarily in all cases. Subsequent flap debulking and minor revisions were performed under local anaesthesia between 6 and 12 months postoperatively. Conclusions: The pre-expanded bipedicled visor flap provides an effective and reliable option for upper and lower lip reconstruction with excellent colour and texture. It is feasible to achieve these results simultaneously from a single donor site by using a pre-expanded bipedicled visor flap.

Keywords

Postburn / Pre-expanded / Visor flap / Lip defect / Reconstruction

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Peiru Min, Jie Li, Beniamino Brunetti, Zheming Pu, Weijie Su, Wenjing Xi, Zheng Zhang, Rosa Salzillo, Shaoqing Feng, Yixin Zhang. Pre-expanded bipedicled visor flap: an ideal option for the reconstruction of upper and lower lip defects postburn in Asian males. Burns & Trauma, 2020, 8 (1) : tkaa005 DOI:10.1093/burnst/tkaa005

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References

[1]

Guo L, Pribaz J. Preexpanded ultra-thin supraclavicular flaps for (full-) face reconstruction with reduced donor-site morbidity and without the need for microsurgery (discussion). Plast Reconstr Surg. 2005; 115: 1845-7.

[2]

Rose EH.Aesthetic restoration of the severely disfigured face in burn victims: A comprehensive strategy. Plast Reconstr Surg. 1995; 96: 1573-85.

[3]

Pallua N, Machens HG, Rennekampff O, Becker M, Berger A. The fasciocutaneous supraclavicular artery island flap for releasing postburn mentosternal contractures. Plast Reconstr Surg. 1997; 99: 1878-84.

[4]

MacLennan SE, Corcoran JF, Neale HW. Tissue expansion in head and neck burn reconstruction. Clin Plast Surg. 2000; 27: 121-32.

[5]

Vinh VQ, Ogawa R, Van Anh T, Hyakusoku H. Reconstruction of neck scar contractures using supraclavicular flaps: Retrospective study of 30 cases. Plast Reconstr Surg. 2007; 119: 130-5.

[6]

Pallua N, von Heimburg D. Pre-expanded ultra-thin supraclavicular flaps for (full-) face reconstruction with reduced donor-site morbidity and without the need for microsurgery. Plast Reconstr Surg. 2005; 115: 1837-44.

[7]

Zan T, Li H, Gu B, Liu K, Xie F, Xie Y, et al. Surgical treatment of facial soft-tissue deformities in postburn patients: A proposed classification based on a retrospective study. Plast Reconstr Surg. 2013; 132: 1001e-14e.

[8]

Yang DP, Zhang P. Facial resurfacing with prefabricated induced expanded skin flap. J Craniofac Surg. 2019; 30: 1131-4.

[9]

Xia CD, Xue JD, Di HP, Han DW, Cao DY, Li Q, et al. Application effects of CT angiography and three-dimensional reconstruction technique in repairing scar around the mouth and chin with expanded forehead axial flap. Chin J Burns. 2018; 34: 677-82.

[10]

Yu DN, Shen YM, Chen X. Effect of axial flap of adjacent artery perforator with vascular pedicle in repairing facial and cervical scar deformity in patients. Chin J Burns. 2019; 35: 848-54.

[11]

Sisti A, D’Aniello C, Fortezza L, Tassinari J, Cuomo R, Grimaldi L, et al. Propeller flaps: A literature review. In Vivo. 2016; 30: 351-73.

[12]

Karonidis A, Yao SF. Chimeric anterolateral thigh free flap for head and neck reconstruction. Plast Reconstr Aesthet Surg. 2009; 62: e85-6.

[13]

Ogawa R. Surgery for scar revision and reduction: From primary closure to flap surgery. Burns Trauma. 2019; 7: 7.

[14]

Keskin M, Sutcu M, Tosun Z, Savaci N. Reconstruction of total lower lip defects using radial forearm free flap with subsequent tongue flap. J Craniofac Surg. 2010; 21: 349-51.

[15]

Jeng SF, Kuo YR, Wei FC, Su CY, Chien CY. Reconstruction of concomitant lip and cheek through-and-through defects with combined free flap and an advancement flap from the remaining lip. Plast Reconstr Surg. 2004; 113: 491-8.

[16]

Daya M. Simultaneous total upper and lower lip reconstruction with a free radial forearm-palmaris longus tendon and brachioradialis chimeric flap. J Plast Reconstr Aesthet Surg. 2010; 63: e75-6.

[17]

Ueda K, Oba S, Nakai K, Okada M, Kurokawa N, Nuri T. Functional reconstruction of the upper and lower lips and commissure with a forearm flap combined with a free gracilis muscle transfer. J Plast Reconstr Aesthet Surg. 2009; 62: e337-40.

[18]

Daya M, Nair V. Free radial forearm flap lip reconstruction: A clinical series and case reports of technical refinements. Ann Plast Surg. 2009; 62: 361-7.

[19]

Dufourmentel L. Essai de reconstruction totale du massif maxillaire inferieur. Reconstr Maxillofac. 1919; 3: 141-56.

[20]

Walton RL, Bunkis J. A free occipital hair-bearing flap for reconstruction of upper lip. Br J Plast Surg. 1983; 36: 168-70.

[21]

Lyons GB, Milory BC, Lendvay PG, Teston LM. Upper lip reconstruction: Use of the free superficial temporal artery hair-bearing flap. Br J Plast Surg. 1989; 42: 333-6.

[22]

Datubo-Brown DD, Khalid KN, Levick PL. Tissue-expanded visor flap in burn surgery. Ann Plast Surg. 1994; 32: 205-8.

[23]

Kulahci Y, Sever C, Uygur F, Oksuz S, Sahin C, Duman H. Pre-expanded pedicled thoracodorsal artery perforator flap for postburn axillary contracture reconstruction. Microsurgery. 2011; 31: 26-31.

[24]

Beheiry EE, Abdel-Hamid FA. An anatomical study of the temporal fascia and related temporal pads of fat. Plast Reconstr Surg. 2007; 119: 136-44.

[25]

Bakhach J, Conde A, Demiri E, Baudet J. The reverse auricular flap: A new flap for nose reconstruction. Plast Reconstr Surg. 1999; 104: 1280-8.

[26]

Song R, Song Y, Qi K, Jiang H, Pan F. The superior auricular artery and retroauricular arterial island flaps. Plast Reconstr Surg. 1996; 98: 657-67.

[27]

Kilinc H, Bilen BT, Ulusoy MG, Aslan S, Arslan A, Sensoz O. A comparative study on superior auricular artery island flaps with various pedicles for repair of periorbital defects. J Craniofac Surg. 2007; 18: 406-14.

[28]

Abul-Hassan HS, von Drasek AG, Acland RD. Surgical anatomy and blood supply of the fascial layers of the temporal region. Plast Reconstr Surg. 1986; 77: 17-28.

[29]

Ma X, Li Y, Li W. Reconstruction of facial-cervical scars with Pedicled expanded Deltopectoral flap. J Craniofac Surg. 2017; 28: 1554-8.

[30]

Margulis A, Agam K, Icekson M, Dotan L, Yanko-Arzi R, Neuman R. The expanded supraclavicular flap, prefabricated with thoracoacromial vessels, for reconstruction of postburn anterior cervical contractures. Plast Reconstr Surg. 2007; 119: 2072-7.

[31]

Peng P, Ding JK, Liu SQ, Tang YK, Chu FF, Wang ZT, et al. Clinical effects of expanded forehead flaps in repairing midfacial defects. Chin J Burns. 2019; 35: 855-8.

[32]

Gonzalez-Ulloa M. Restoration of the face covering by means of selected skin in regional aesthetic units. Br J Plast Surg. 1956; 9: 212-21.

[33]

Hafezi F, Naghibzadeh B, Nouhi A. Facial reconstruction using the visor scalp flap. Burns. 2002; 28: 679-83.

[34]

Pierce GF, Vande Berg J, Rudolph R, Tarpley J, Mustoe TA. Platelet-derived growth factor-BB and transforming growth factor beta 1 selectively modulate glycosaminoglycans, collagen, and myofibroblasts in excisional wounds. Am J Pathol. 1991; 138: 629-46.

[35]

Chang B, Tuchler RE, Siebert JW, Longaker MT, Burd DA. The effect of tissue expansion on dermal fibroblast contraction. Ann Plast Surg. 1992; 28: 315-9.

[36]

Callegari PR, Taylor GI, Caddy CM, Minabe T. An anatomic review of the delay phenomenon: I. Experimental studies. Plast Reconstr Surg. 1992; 89: 397-407.

[37]

Zhang GL, Zhang JM, Ji CY, Meng H, Huang JH, Luo HY, et al. Hong XF. A comparison of skin expansion and contraction between one expander and two expanders: A preliminary study. Aesthetic Plast Surg. 2013; 37: 1202-8.

[38]

Gunji H, Sanbe N, Tateshita T, Yoza S, Ono I. Reconstruction of scalp defect with hair-bearing skin flap pedicled by superficial temporal arterial and venous system. Jpn J Plast Reconstr Surg. 1997; 17: 514-25.

[39]

Ausen K, Pavlovic I. Flaps pedicled on the superficial temporal artery and vein in facial reconstruction: A versatile option with a venous pitfall. J Plast Surg Hand Surg. 2011; 45: 178-87.

[40]

Tenna S, Brunetti B, Aveta A, Poccia I, Persichetti P. Scalp reconstruction with superficial temporal artery island flap: Clinical experience on 30 consecutive cases. J Plast Reconstr Aesthet Surg. 2013; 66: 660-6.

[41]

Hocaoğlu E, Emekli U, Çızmecı O, Uçar A. Suprafascial pre-expansion of perforator flaps and the effect of pre-expansion on perforatorartery diameter. Microsurgery. 2014; 34: 188-96.

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