Long-Term Outcomes of Prefabricated Flaps Vascularized By the Parietal Branch of the Superficial Temporal Artery for Facial Reconstruction.

Background: Prefabricated flaps are a versatile technique for reconstructing facial defects. This study presents a long-term follow-up study of prefabricated flaps carried by fascia flaps based on the parietal branches of the superficial temporal artery (STA-pb-based fascia flap) for facial reconstruction.

Methods: Between November 2004 and January 2007, 14 patients who underwent facial reconstruction using prefabricated flaps carried by STA-pb-based fascia flaps were retrospectively reviewed. All patients completed long-term follow-up, and aesthetic outcomes were assessed using the Facial Assessment and Cosmetic Enhancement Quality of Life Questionnaire (FACE-Q).

Results: This study included 8 male and 6 female patients with a mean age of 13.5 years. Etiologies comprised postburn scars (n=9), congenital or sebaceous nevus (n=3), and hemangioma (n=2). Donor sites for flap prefabrication included the forehead (n=4), postauricular (n=5), and cervical region (n=5). The mean defect size was 10.2×6 cm2, and the average dimension of the STA-pb-based fascia flap was 6.3×5 cm2. Prefabricated flaps averaged 11.6×6.3 cm2 in size. One patient developed venous congestion in a postauricular flap. After conservative management, the flap survived completely. Another patient experienced necrosis of the distal 1 cm of the flap, which healed with conservative dressing. The follow-up ranged from 5 to 20.2 years. FACE-Q results indicated high patient satisfaction in all domains.

Conclusions: Prefabricated flaps carried by STA-pb-based fascia flaps offer an effective option for facial defect reconstruction. With ongoing advances in perfusion assessment and accelerated flap maturation techniques, this method is expected to become increasingly reliable and widely applicable in facial reconstructive surgery.