Studies on pathological-scar management including conservative and surgical therapies have increased markedly over the last decade. They have greatly improved burn and scar management.
Especially, thin and large flaps are necessary for the reconstruction of wide and contour-sensitive areas such as face and neck in extensive post-burn scar contracture cases. Perforator-supercharged thin flaps are useful for these cases. A discriminating feature of thin flap is its extremely thin form according to the intraoperative primary defatting. It is primarily thinned to the layer where the subdermal vascular network (subdermal plexus) can be seen through the minimal fat layer. Perforators as vascular pedicles have an advantage for defatting of large areas in the flap, and extremely long and large flaps can be harvested according to the perforator supercharging.
In pursuit of a successful outcome in surgical correction of burn scars using local flaps, the flaps should be harvested according to an optimized design. With the counterbalance of both technical difficulties and elongation rates in mind, the type of flap (island or skin pedicle) utilized for treatment should be carefully evaluated. The results of our study suggests that the island flap treatment requires a relatively uncomplicated process, whereas the skin pedicle flap treatment acquires better extensibility over the course of half a year. In this meaning, the square flap methods are useful for minor scar contracture cases. The square flap method is an effective way to elongate the skin. We have used this method to reconstruct scar contracture-bearing axillary and first digital webs, and assessed its ability to release the scar contracture and improve joint function.

Download