The neck includes important anatomical structures, such as primary blood vessels, nerves, the esophagus, the trachea, and others. Defects in the area of the neck can be a result of the removal of tumors, which are generally malignant, or injury, such as burns. Scars after surgery in this area run the risk of inhibiting neck movement, and sometime require corrective surgery.
Reconstructive surgery in this area is made possible by using local skin flaps for the purpose of repairing the scars from burns that limit movement or present a significant esthetic disturbance. These scars can be treated by stretching and the recruitment of adjacent skin. This is done by using expansion techniques on the skin proximal to the scarred area, introducing capsules (tissue expanders) under the skin during initial surgery. The capsule is left under the skin for several weeks, and expanded by the gradual injection of physiological saline solution via a special port connected to the capsule and placed under the proximal skin. In a second procedure, the capsule is removed and the expanded skin is moved to the area being treated.
If the defect is larger, it is necessary to transfer flaps of muscle with or without skin from proximal areas, such as the chest or upper back. These flaps include the pectoralis major muscle and the trapezius muscle from the upper back area.
In cases where it is not possible to use flaps from the area proximal to the neck, it is necessary to transplant free flaps. These flaps are transferred together with the blood vessels supplying them, which are then connected to the recipient blood vessels in the area of the defect using microsurgical techniques. The flaps generally used are flaps of skin and fat from the area of the front of the thigh or the back, or flaps of muscle from the back.