Bilateral unexpanded supraclavicular flaps for single-stage resurfacing of anterior neck contractures

Abstract

Context: Anterior neck scar contracture causes functional and esthetic deformity which is difficult to conceal. Supraclavicular flap is an accepted modality for neck scar reconstruction but has limitations of reach and skin deformation if used as a pedicled flap. Island flap and propeller modification can allow primary closure of donor site. Aims: The aim of the study is to assess the efficacy of bilateral supraclavicular unexpanded flaps in single-stage release and resurfacing of anterior neck contractures. Subjects: Seven cases of anterior neck contracture were operated with release and flap cover. Grades of contracture treated were Onah 2b, 2c, 3b and 3c. Methods: All cases underwent single stage release and resurfacing with bilateral propeller island supraclavicular flaps. Patients were followed up fo an average 30+/- 10 months using extension angle to check for recurrence. Results: All cases achieved satisfactory cosmesis at 1year followup. The average increase in neck extension angle achieved at 1 year was 22.9° ± 10°. No recurrence of contracture was noted. One flap had partial necrosis requiring skin graft. Two cases had axilla scarring requiring graft closure for donor site. Average flap length was 14.4 ± 1.7 cm. Average flap width was 7.1 ± 1 cm. Conclusions: Bilateral supraclavicular flaps can be used to resurface anterior neck contractures in a single stage with acceptable donor-site morbidity.

Keywords

• anterior neck contracture
• bilateral supraclavicular flap
• island propeller flap