The elimination of postburn nasal contracture in children with trapeze-flap plasty.

One consequence of a facial burn is nasal contracture. In pediatric patients, scar tension presents a particular problem because of facial growth. The forehead and nasal scar contraction deform the nose dorsum, especially between the eyes. The nasofrontal angle becomes smoothened, wide, and flat; the scar edges cover the inner canthus. The dorsum nose scar stretching delays nasal development, pulls the nose up, making it shorter, and causes nasal ectropion. Secondary deformity of the nose's solid structures develops as a consequence of scar contracture, and its reconstruction poses a major problem. At the same time, it is suggested that nasal reconstruction in the pediatric patients should be planned as a staged procedure. Therefore, scar contracture release should be performed early, at the first stage of pediatric nasal reconstruction, to create conditions for normal nasal development. In this author's opinion, the most suitable procedure is trapeze-flap plasty. The scar tissue surplus in the nasofrontal angle allows contracture release with local tissues. Reconstruction with local trapezoid flaps releases the scar tension and elongates the nasal dorsum surface by approximately 1.5 cm; the epicanthus is eliminated, and the nasofrontal angle (nasal root) is restored. Eight children were operated. Good results were observed in all patients for the duration of 3 years.