Reconstruction of Post Burn Ala Defect Using Adiposocutaneous Graft.

Kwon, Min Joo; Lee, Jong Wook; Koh, Jang Hyu; Seo, Dong Kook; Choi, Jai Ku; Jang, Young Chul

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2011;38(4):451-457.
Published online July 1, 2011.

Reconstruction of Post Burn Ala Defect Using Adiposocutaneous Graft.

Min Joo Kwon, Jong Wook Lee, Jang Hyu Koh, Dong Kook Seo, Jai Ku Choi, Young Chul Jang

Department of Plastic and Reconstructive Surgery, School of Medicine, Hallym University, Seoul, Korea. jwlpsdoc@yahoo.co.kr

Abstract

PURPOSE
As a central feature of the face, the nose has considerable significance in appearance and expression. Reconstruction of full thickness defects of the nasal ala has always been a challenge because of the 3-dimensional structure. For reconstruction of post burn defects of ala, skin graft, local or pedicled flap and composite graft are optionally available. We have reconstructed the ala defects using adiposocutaneous graft and observed the outcome. METHODS: From March 2003 to December 2010, 19 cases in 11 patients with scar contracture and defect on ala portion were performed operation using adiposocutaneous graft. As a donor site, we used the inguinal crease and posterior auricular area and the donor site was primarily closed. We made incision through the superior rim of ala and released fully. A graft is applied to recipient site with larger size than recipient volume.
RESULTS
The mean age of the patient was 38.6 years (16~51), males are seven patients and females are four patients. The operation was performed bilaterally in 5 patients and unilaterally in 6 patients. Composite grafts were harvested from inguinal area in 13 cases and posterior auricular area in 6 cases. In one case, we did 4 times of operation to get enough volume. All the grafts were well taken. The mean size of the graft was 3.63 cm2.
CONCLUSION
For reconstruction of post burn defects of ala, it's not easy to use local flap or pedicled flap because of hardness and fibrosis of surrounding tissue. So, we choose adiposocutaneous graft for ala deformity reconstruction, got satisfactory outcome in color matching and texture.

Keywords: Post burn ala defect; Ala reconstruction; Adiposocutaneous graft

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