Sử dụng vạt da nhánh xuyên hai cuống mạch tự do vùng lưng khác bên trong tạo hình di chứng bỏng toàn bộ vùng mặt

Objectives: Nowadays, the face and neck reconstruction for post burn patients always challenged the plastic surgeons. The materials are requested to be large, thin and same color, texture with face area. Conventional methods are till not yet satisfied this request. Perforator supercharge super-thin flap was introduced in 1994 by Hyakusoku and Gao. The super-thin flap is a distinctively thin flap primary thinned to the layer where the subdermal vascular network can be seen through minimal fat layer. For the reconstruction of severely disfigured neck and face, large and thin flap such as the occipito-cervicodorsal (OCD) "super-thin flap" should be harvested from the dorsal region with surpercharging of the circumflex scapular vessels. Recently, the authors have applied dorsal double contralateral perforators "superthin" free flap for reconstruction of whole face severe scar contracture in post burn patients. Subjects and Methods: Twenty one patients included 8 male and 13 female were admitted at Department of Plastic and Reconstructive Surgery of National Institute of Burn since January, 2011 to December, 2013. Range of age from 15 to 48 years old. Twenty one dorsal double contralateral perforators free flaps were designed in the dorsal. Flap with circumflex scapular artery perforator and contralateral posterior intercostal perforators including of the flap was designed at dorsal. Recipient are superficial temporal artery and contralateral facial artery or contralateral superficial temporal artery. The fate tissue between two pedicles was thinned before pedicles dividing. Maximum the authors can be obtained 35x20cm. Detail of technique will be discussed in the paper. Results: Nineteen flaps survived completely and two flaps happened a part necrosis. The donor site was covered by using split full-thickness skin graft. The patients were satisfied with both cosmetically and functionally. Conclusion: Dorsal double perforators super thin free flap is new option in severe neck contracture scar reconstruction.