Traditionally, burn reconstructions have been performed by the use of skin grafting or local flaps. Recently free flaps are being used with increasing frequency. Although not very common in the head neck region, free flaps are mostly used for secondary reconstructions of cervicofacial contractures. We report the role of free flaps in postburn facial reconstructions, excluding neck and scalp burns. Sixteen free flaps used for postburn facial reconstructions were reviewed retrospectively, during the period between 2003 and 2023. The etiology, indications, timing, location, choice of the flap, type of reconstruction, and outcomes were analyzed. Indications and type of reconstructions were categorized to correlate with flap choice. The age of the patients ranged between 8 and 40 years. The etiology included electrical burns in six cases, flame burns in eight cases, and acid burns in two cases. Nine defects were in the central part of the face including the nose and the chin. Two primary and 14 secondary reconstructions were performed using free flaps from lateral thigh in 11 cases, lateral arm in 2 free flaps cases, radial forearm in 2 free flaps cases, and the posterior auricular flap in 1 case. There were no total flap failures. Secondary procedures were needed in 10 of 13 evaluable patients. Free flaps provide a good and safe option for selective postburn reconstructions in the face. The choice of flap mainly depends on the indication and type of reconstruction needed, apart from the availability of donor tissue and the surgeon's preference. Complex reconstructions may need larger and composite flaps to replace the components. Multiple secondary procedures are needed to achieve the objectives.
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http://dx.doi.org/10.1055/s-0044-1790512 | DOI Listing |
Microsurgery
January 2025
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
Background: The deep inferior epigastric perforator (DIEP) flap is currently the gold standard for autologous breast reconstruction. In cases where the DIEP is contraindicated, the profunda artery perforator (PAP) flap is now the preferred second-line option in our institution. The PAP flap poses unique challenges to the reconstructive surgeon, especially in Asian women with low body mass index (BMI).
View Article and Find Full Text PDFJ Korean Assoc Oral Maxillofac Surg
December 2024
Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Indian J Plast Surg
December 2024
Department of Burns and Plastic Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India.
We present the case of a 36-year-old male patient with a posttraumatic composite defect of the lower two-thirds of the anterior aspect of the left leg with exposed necrotic tibia in an old, neglected type 3b fracture of the tibia of 9-month duration. The options for definitive soft-tissue cover include microvascular free tissue transfer and cross-leg flaps. In trauma cases, the surrounding tissue is usually damaged, and the recipient vessels are frequently implicated, ruling out the use of a microvascular free flap.
View Article and Find Full Text PDFIndian J Plast Surg
December 2024
Department of Plastic and Reconstructive Surgery, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Traditionally, burn reconstructions have been performed by the use of skin grafting or local flaps. Recently free flaps are being used with increasing frequency. Although not very common in the head neck region, free flaps are mostly used for secondary reconstructions of cervicofacial contractures.
View Article and Find Full Text PDFIndian J Plast Surg
December 2024
Department of Plastic and Reconstructive Surgery, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
A 21-year-old male laborer sustained bilateral degloving injury of the hands with multiple digital amputations and devascularized digits. After X-rays, preliminary debridement was done, when digital amputations were completed, including index ray amputation on both sides. The next day, two anterolateral thigh (ALT) flaps and one second toe transfer were done to restore coverage in the palm and the web and reconstruct the lost thumb.
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