The prefabricated superficial temporal fascia flap in noma surgery

In a series of 15 patients with facial deformity due to noma, the authors r eport their experience with a prefabricated superficial temporal fascia (PT F) flap performed in an African hospital. The operative method has been sim plified as compared with methods described by others. In the first stage, t he temporal fascia is skin grafted and the wound is closed over the graft. After only 1 week, this prefabricated flap is harvested. One of 15 flaps wa s discarded because of damage to the vascular pedicle. Later this situation was prevented by including a rim of deep temporal fascia in the flap. All other 14 flaps, including four osteocutaneous flaps and one flap with doubl e sided skin grafts, survived and healed without major complications at bot h the recipient and the donor site. The prefabricated temporal fascia flap is a pliable and well vascularized nap with a reasonably long vascular pedi cle, which can be used successfully, even under suboptimal conditions.