Abstract
Many surgical procedures, such as skin grafts, local flaps, z-plasties, regional flaps, free flaps and perforator flaps, can be used for anterior neck scar contracture reconstruction. Moreover, there are now numerous choices available, such as flap prefabrication, preexpansion and super-thin flaps. However, it is still difficult to make algorithms of treatments of anterior neck scar contracture reconstruction. Thus, we reviewed existing papers and discussed current problems and future perspectives for this field.
It can be considered that short linear contractures can be released using single z-plasty or a small local flap. However, long linear contractures that extend to the next unit should be reconstructed using multiple z-plasties, local flaps or skin grafting. With respect to skin grafting, FTSG should be selected to prevent re-contracture. Broadband contracture should be released completely and reconstructed using FTSG or thin flaps. If the platysma is missing, thin flaps should be used instead of skin grafting. Broadband contracture extending to the next unit should be reconstructed using a sheet of large and thin flaps, such as perforator supercharged super-thin flaps. It can be concluded that we should study the advantages and disadvantages of each type of flap using strict evaluations.
