Unilateral Neck Scar Contracture and Deformity Elimination with Contralateral Split Neck Flap

Abstract

Scars covering one anterior side of the neck can cause contracture and severe cosmetic defects. Therefore, treatment is considered adequate when both defects are eliminated simultaneously. This means that scars should be replaced by tissue similar to healthy neck skin and without creating operating scars on the anterior surface of the neck. Skin grafting of the neck does not produce satisfactory results; the shrinkage of skin transplants remains an insuperable complication. Skin of regional and free flaps differs in color and elasticity. Moreover, the operation scars usually pass along the medial neckline. The best results can be achieved by using the healthy skin of the contralateral surface of the neck in a form of whole neck split flap. It can be achieved by using an expander implanted under undamaged neck skin. The process of expansion of the neck skin, however, may be complicated by tissue necrosis. Having studied the neck skin blood supply (Chap. 6) and possibilities of a split flap (without platysma), we successfully used neck split flap for single-stage unilateral neck resurfacing.