Résumé
Objective@#To observe the effects of the method of combining free superficial temporal fascia flaps with skin grafts in repairing deep wounds in posterior ankle region of extensively burned patients.@*Methods@#From September 2013 to February 2017, 11 extensively burned patients with deep tissue defects in posterior ankle region were treated in our unit. Two patients had tissue defects in bilateral posterior ankle regions. The wound sizes ranged from 5.8 cm×4.6 cm to 11.7 cm×5.2 cm. Free superficial temporal fascia flaps with the same sizes as the wounds were designed and resected to repair wounds in posterior ankle regions after debridement. The proximal end of superficial temporal veins and posterior tibial veins were performed with end-to-end anastomosis, and superficial temporal arteries and posterior tibial arteries were performed with end-to-side anastomosis. Skin grafts were resected to cover the superficial temporal fascia flaps according to patients′ condition of donor sites. The donor sites were sutured directly.@*Results@#All fascial flaps in 11 patients survived, while 2 skin grafts had partial necrosis, and they healed after secondary skin graft. All patients were followed up for 6 to 13 months, and the shape and function of the operation sites in all patients recovered well.@*Conclusions@#The method of combining free superficial temporal fascia flaps with skin grafts can repair deep wounds in posterior ankle regions of extensively burned patients. It has the advantages of good appearances in the recipient sites, strong resistances to infection of fascia flaps, minimal damages to the donor sites, short course of disease, and good prognosis of patients.
Résumé
The superficial temporal fascia is a thin, pliable, well- vascularized flap that is useful in elevation of the reconstructed ear of the microtia. However, the elevation of the superficial temporal fascial flap by conventional T or zigzag incisions in temporal region frequently leaves a conspicuous scar, hair thinning and alopecia. To overcome these problems, we harvested the superficial temporal fascia as a random pattern flap using only a retroauricular skin incision line for the ear elevation. Thereafter, the cartilage framework was elevated including superficial temporal fascia and superficial mastoid fascia underneath: dissection plane was continuous with the superficial temporal fascial flap harvest and dissection was performed just beneath the superficial mastoid fascia under the framework. A carved costal cartilage block was grafted at the posterior wall of the concha and covered with the harvested superficial temporal fascial flap, followed by a full-thickness skin graft. From June 2001 to December 2001, 9 patients (male 8 and female 1), who ranged from 9 to 26 years in age, underwent ear elevation using this method. The skin grafts was successful and the appropriate auriculocephalic angle was preserved in all cases. We did not find any complications such as infection, graft loss or cartilage extrusion in the 3 to 9 months follow-up period and the patients were satisfied with their cosmetic results. This method was easy to perform and did not leave any other scar in the temporal hear-bearing area and the results have been favorable.