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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  >  > Accepted Manuscript
Xia Chengde,Xue Jidong,Di Haiping,et al.Clinical effects of expanded superficial temporal artery double-pedicled flaps in reconstructing scar contracture deformities after burns in the mid and lower face[J].Chin J Burns Wounds,2026,42(4):1-8.DOI: 10.3760/cma.j.cn501225-20260103-00001.
Citation: Xia Chengde,Xue Jidong,Di Haiping,et al.Clinical effects of expanded superficial temporal artery double-pedicled flaps in reconstructing scar contracture deformities after burns in the mid and lower face[J].Chin J Burns Wounds,2026,42(4):1-8.DOI: 10.3760/cma.j.cn501225-20260103-00001.
shu

Clinical effects of expanded superficial temporal artery double-pedicled flaps in reconstructing scar contracture deformities after burns in the mid and lower face

doi: 10.3760/cma.j.cn501225-20260103-00001

  • Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China

Funds:

​ National Clinical Key Specialty Construction Project 2023-70

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  • Corresponding author: Wang Yingqiu, Email: 2273451508@qq.com
  • Received Date: 2026-01-03
    Available Online: 2026-03-30
    Abstract
  •   Objective  To explore the clinical effects of using expanded superficial temporal artery double-pedicled flaps in reconstructing scar contracture deformities after burns in the mid and lower face.  Methods  This study was a retrospective investigation of case series. From January 2020 to January 2025, 20 male patients with scar contracture deformities after burns in the mid and lower face who met the inclusion criteria were admitted to the First People's Hospital of Zhengzhou, aged 15 to 56 years, with a disease course of 1 to 10 years. Among them, 16 patients had scar contracture of the upper and lower lips with small mouth malformation and lip eversion, with a mouth opening degree of 2.0 to 2.5 cm. The expanded superficial temporal artery double-pedicled flap was used to reconstruct the scar contracture deformity. The surgery was divided into three stages. In stage Ⅰ, a cylindrical skin soft tissue expander (hereinafter referred to as expander) with a rated capacity of 500 to 900 mL was placed on the top of the head. If necessary, another expander with a rated capacity of 100 to 200 mL was placed on one or both sides of the temporal region. After surgery, regular water injection was performed for expansion to achieve a final water injection volume of 2 to 3 times the rated capacity of the expander. Five to 6 months after stage Ⅰ surgery, stage Ⅱ surgery was performed. An expanded flap (with an area of 35 cm×11 cm to 54 cm×19 cm) pedicled with bilateral superficial temporal artery top or frontal branches was used to repair the wound formed after scar removal and contracture release. For scar contractures that simultaneously affected both upper and lower lips, a transverse incision of about 6 cm in length was made at the position of the flap corresponding to the normal oral fissure, forming a new oral fissure and restoring the normal position of the mouth corner. The width of the flap used as the upper lip was adjusted to 2.5 to 3.0 cm. The donor site wound was directly sutured, and the incomplete closure was temporarily covered by scar skin patches. Three to 4 weeks after stage Ⅱ surgery, stage Ⅲ surgery was performed, including flap pedicle division and pedicle repair and reset, etc. The expansion of the flap, the survival of the flap and the occurrence of complications after stage Ⅱ surgery, and the thinning of the flap in the later period were recorded. During follow-up, the degree of improvement in the appearance and function of the mid and lower face was evaluated, the appearance and texture of the flap, and the formation of scars in the donor area were observed. Twelve months after stage Ⅲ surgery, the mouth opening degree of 16 patients with small mouth malformation was measured, and the visual analogue scale was used to evaluate the satisfaction of all patients with the improvement of appearance and function of face.  Results  All 20 patients successfully completed flap expansion. In the early period post stage Ⅱ surgery, three patients experienced venous reflux obstruction and mild congestion in the flaps, which resolved spontaneously after one week; the flaps of the remaining patients survived well. Five patients underwent thinning surgery three months after stage Ⅲ surgery due to slightly thick flaps. Follow up for 12 to 24 months after stage Ⅲ surgery showed significant improvement in the appearance of the mid and lower face in all patients, as well as significant improvement in oral opening and closing, chewing, and language function; the color and texture of the flaps were similar to those of the surrounding skin tissue in the recipient area, and linear scars were left in the donor area located at the hairline. Twelve months after stage Ⅲ surgery, the mouth opening degree of 16 patients with small mouth malformation increased to 3.5 to 4.0 cm; the satisfaction scores for facial appearance improvement were 8-10 in 18 cases and 6-7 in 2 cases, while the satisfaction scores for facial function improvement were 9-10 in 19 cases and 7-8 in 1 case.  Conclusions  The expanded superficial temporal artery double-pedicled flap has reliable blood supply, a large cutting area, and a long transfer distance. The application of this flap in the reconstruction of scar contracture deformities after burns in the mid and lower face causes minimal damage to the donor area, with good concealment. It can effectively improve facial appearance and function and is worthy of clinical promotion.

     

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