Innovative technique creates large skin flaps for full-face resurfacing

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.
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.’
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 expanders