The ‘expansile’ supraclavicular artery flap for release of post-burn neck contractures Mamoon Rashid*, Muhammad Zia-ul-Islam, Saad-ur-Rahman Sarwar, Ahsan Manzoor Bhatti Department of Plastic Surgery, Combined Military Hospital, Rawalpindi, Pakistan Received 31 May 2005; accepted 28 December 2005 KEYWORDS Supraclavicular artery flap; Neck contracture; Flap stretching; Burn reconstruction; Fasciocutaneous flap Summary Soft tissue defects in the cervico-facial region can result from trauma, tumour excision or post-burn scarring. All rungs of the reconstructive ladder offer possible reconstructive options for these defects. The supraclavicular artery based flap is an extremely reliable local flap for this purpose. It offers thin and pliable skin with good colour match and minimal donor site morbidity. An additional advantage, in our experience, is that this skin can stretch postoperatively to allow further improved neck contour and mobility. Materials and methods: Between June 2000 and January 2004, 27 patients under- went reconstruction of neck defects after release of post-burn contractures with the supraclavicular artery based skin flap at our hospital. After discharge the first follow-up visit was on the 10th postoperative day. The patients were advised to wear a custom made Watusi splint for 3 to 4 months. The patients were subsequently followed up at 3 months, 6 months and 1 year. The dimensions of the flap were measured and the patients photographed at the time of discharge and at subsequent visits. Results: All the flaps survived completely. The average operating time for contrac- ture release and flap coverage was 2 h. The hospital stay ranged from 5 to 8 days. Follow-up ranged from 1 to 4 years with an average of 22 months. Complications included epidermolysis (n ¼ 2) and delay in donor site healing (n ¼ 2). Almost all patients had some widening of the donor site scar. In our experience the width of the flap increased in the postoperative period. At the time of surgery, the width of the flap ranged between 9 and 12 cm. At the 3-month follow-up there was an average increase in width of 24.2%. At 6 months, the average increase in width was 42.8% of the original flap width. At 1 year the * Corresponding author. 185 ‘The Haven’, Street 7, Gulraiz II, Rawalpindi, Pakistan. Tel.: þ92 5817485. E-mail address: mamoon@isb.comsats.net.pk (M. Rashid). 1748-6815/$ - see front matter ª 2006 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2005.12.058 Journal of Plastic, Reconstructive & Aesthetic Surgery (2006) 59, 1094e1101