Functional facial reconstruction in a patient with severe burn sequelae with a prelaminated parascapular free flap based on a three-dimensional model: A case report

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Ricardo José Moreira Horta Oliveira

    Autor

Participantes de fora da FMUP

  • Monteiro, D
  • Orfao, T
  • Nascimento, R
  • Frias, F
  • Silva, A

Unidades de investigação

Abstract

Significant evolution has been made concerning resuscitation and emergency management of severely burned patients, and nowadays most patients will survive and deal with burns sequelae. They constitute a reconstructive challenge, mainly because options and donor areas are frequently compromised, results are often limited, and other options should then be considered. A 27-year-old male patient with 55% total burn surface area, presented with severe facial disfigurement including ectropion, upper/lower lip retraction, and partial loss of the nose. In order to improve the patient's condition, autologous reconstruction was considered. The only unburned area in the body was the left dorsal region, and a three-stage reconstruction was planned using a paraescapular flap. In a first stage, an elective surgery was performed to identify and tag the recipient vessels in the neck. After 3 months, the prelamination process was initiated with the drawing of a facial model, and a nose and lips were opened inside the flap. This was based on a three-dimensional latex model as a print of the patient's face, which allowed us to calculate distances and estimate the length of the vascular pedicles. After 3 months, the flap (18 x 8 cm) was transferred and microvascular anastomoses were performed. No major complications were seen after surgeries, and after 28 months, an extremely important functional gain was obtained. Despite the number of surgeries required and less than optimal aesthetic results, this method may offer a satisfactory solution for complex acquired facial burn sequelae when other local or distant flap options are not available.

Dados da publicação

ISSN/ISSNe:
1098-2752, 0738-1085

Microsurgery  Wiley-Liss Inc.

Tipo:
Article
Páginas:
802-807
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 1

Citações Recebidas na Scopus: 2

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Keywords

  • Adult; Burns; Esthetics; Facial Injuries; Free Tissue Flaps; Humans; Male; Nose; Reconstructive Surgical Procedures; adult; Article; burn; case report; clinical article; dorsal region; ectropion; elective surgery; eye protection; face burn; face deformity; face surgery; forearm; free tissue graft; human; human tissue; lip; male; nose; parascapular flap; priority journal; skin graft; skin transplantation; surface area; vascular pedicle; burn; complication; esthetics; face injury; reconstructive surgery

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