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Subplatysmal Flap

Subplatysmal Flap

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Preoperative Considerations

Consent:

  • Discuss neck incision/expected scarring
  • Numbness in great auricular distribution
  • Marginal mandibular/cervical weakness 

Anesthesia/Positioning:

  • Supine
  • Shoulder roll for neck extension
  • Paralytics are OK 

Other:

  • None

Armamentarium:

  • Local anesthesia
  • Monopolar/Bipolar Electrocautery
  • #15/10 blade
  • Double prong skin hooks
  • Debakey
  • Vascular Clips (S/M)
  • Tonsil
  • Fish hooks/ Lone star self retaining retractor
  • 3-0 Vicryl
  • Skin sutures

Technique

A person with lines on his neckDescription automatically generated
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The flap should encompass skin, subcutaneous tissue, platysma
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  • Hemostasis should be ensured prior to closure
  • Can apply a hemostatic agent as pictured
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Postoperative Considerations

Immediate:

  • Q4 drain output PRN
  • Bacitracin to wound

Follow Up:

  • None

Operative Note

Coding

Forms

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