Clinical Application of Pre-Expanded Perforator Flaps

Reconstruction of Facial Multiunit Defects Using Expanded Scalp Flap with Laser Depilation in a Group of Predominantly Pediatric Patients

Background: The cervical or thoracic region is currently the main donor site for repair of facial multiunit defects (FMUDs); however, its extensive clinical utilization encompasses the need for flap prefabrication and microsurgical techniques. Objective: To illuminate the feasibility of treating FMUD with expanded scalp flaps and laser depilation. Methods: From 2016 to 2020, 17 patients with facial giant congenital melanocytic nevi (GCMN) underwent scalp expansion for FMUD reconstruction. A three-stage surgical treatment plan was attempted and laser depilation was scheduled during the expansion period and postrepair surgeries. Results: All the flaps survived successfully and were able to cover the entire facial defect. The average three-stage treatment time was 4.5 ± 1.3 months. The defect sites included the forehead, nose, cheek, temporal, and eye areas. The maximum defect area was 9 × 30 cm. The average number of laser treatments was 4.6 ± 2.9 times. The average treatment period was 26.8 months. Sixteen patients (94.1%) reported satisfactory outcome. Conclusion: Expanded scalp flap combined with laser depilation is feasible for FMUD repair and warrants further investigation. Clinical Trail Registration Information: Translational Medicine Ethics Review Committee, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine (SH9H-2021-T144-3).