PUBLIC RELEASE DATE:

5-Feb-2014

Contact: Connie Hughes Connie.Hughes@wolterskluwer.com 646-674-6348 Wolters Kluwer Health

Philadelphia, Pa. (February 4, 2014) - Patients with massive burns causing complete loss of the facial skin pose a difficult challenge for reconstructive surgeons. Now a group of surgeons in China have developed an innovative technique for creating a one-piece skin flap large enough to perform full-face resurfacing, reports The Journal of Craniofacial Surgery, published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Dr. QingFeng Li and colleagues of Shanghai Jiao Tong University School of Medicine describe their approach to creating "monoblock" flaps for use in extensive face skin resurfacing. In their successful experience with five severely disfigured patients, the full-face tissue flap "provides universally matched skin and near-normal facial contour."

New Technique Grows One-Piece Skin Flaps for Full-Face Resurfacing

Complete destruction of the facial skin and underlying (subcutaneous) tissues presents "the most challenging dilemma" in facial reconstructive surgery. Multiple skin flaps and grafts are needed to provide complete coverage, creating a "patchwork" appearance. Standard skin grafts are also too bulky to provide good reconstruction of the delicate features and expressive movement of the normal facial skin.

To meet these challenges, Dr. Li and colleagues have developed a new technique for creating a single, large skin flap appropriate for use in full-face resurfacing. Their approach starts with "prefabrication" of a flap of the patient's own skin, harvested from another part of the body. The skin flap, along with its carefully preserved blood supply, is allowed to grow for some weeks in a "pocket" created under the patient's skin of the patient's upper chest.

Tissue expandersballoon-like devices gradually filled with saline solutionare used to enlarge the skin flap over time. While skin expansion is a standard technique for creation of skin flaps, Dr. Li and his team used an "overexpansion" approach to create very large flaps of relatively thin skinideal for use in the facial area. In some cases, when the skin flap was growing too thin, stem cells derived from the patients' own bone marrow were used as an aid to tissue expansion.

Using this technique, Dr. Li and colleagues were able to create very large skin flapsup to 30 30 cmfor use in full-face resurfacing. In the new article, they describe their use of their prefabrication/overexpansion technique in five patients with complete loss of the facial skin, caused by flame or chemical burns. All patients had previously undergone facial reconstruction, but were left with severe deformity and limited facial movement.

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Innovative technique creates large skin flaps for full-face resurfacing