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Related Experiment Videos

Total face reconstruction with one expanded free flap.

Hiroyuki Sakurai1, Masaki Takeuchi, Osamu Fujiwara

  • 1Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Surgical Technology International
|March 10, 2006
PubMed
Summary
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This study presents a novel single free-expanded flap technique for total face reconstruction after severe burns. This innovative approach successfully restored facial form and function, including the nose, in one procedure.

Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Burn Reconstruction

Background:

  • Severe facial burns pose significant reconstructive challenges, with traditional skin grafting yielding limited success.
  • Previous total face reconstruction methods, like bilateral extended scapular free flaps, offered improved outcomes but had high donor-site morbidity and required separate nasal reconstruction.

Observation:

  • A 54-year-old male with extensive facial, neck, chest, and upper extremity burns underwent sequential debridement and skin grafting.
  • A large (28x27 cm) left dorsal tissue-expanded flap was successfully transferred for total face reconstruction, including the nose, in a single procedure.

Findings:

  • The single free-expanded flap achieved total survival and provided ample tissue for nasal reconstruction.
  • Five complementary procedures, including a costal cartilage graft, restored nasal shape, yielding acceptable functional and aesthetic results.

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  • This technique eliminated the need for separate tissue transfer for nasal reconstruction, a first for total face reconstruction.

    • Implications:

    • This single free-expanded flap technique offers a promising alternative for total face reconstruction in severe burn cases.
    • It potentially reduces donor-site morbidity and the number of surgical procedures compared to previous methods.
    • This approach advances reconstructive plastic surgery by enabling simultaneous reconstruction of the entire face and nose with a single flap.