[Retrospective study of third degree cervico-facial burns]

Cervical and facial burns can be responsible of social and professional exclusions, functional limitations and psychological repercussions. Composite allotransplantation has become a reality for complex facial reconstructions. The purpose of this study is to evaluate the sequelae of third degree facial burns that might fit into a facial transplant program.

We conducted a retrospective study in our burn unit from May 2006 to July 2009. We included all the patients with third degree cervico-facial burns. One hundred and eighty seven patients were selected. We excluded 87 patients for insufficient initial photography or lack in the medical data. The topography of the facial burns was analysed for each patient and separated into different aesthetic sub units. A questionnaire was mailed to the patients evaluating the psychological, functional and aesthetic sequelae.

The follow-up was of 12 months at least. Of the 100 patients, 82 presented with partial facial burns and 18 with full facial burns. Of the 82 patients with partial burns, 48% had burns in the chin area, 45% in the neck area, 41% in the cheeks and 37% in the ears. The sub units associated with functional sequelae were the neck (32%) and the peri-buccal and peri-orbital region (11-14%). On the 100 questionnaires, 28 patients responded.

Third degree burns sequelae concerned mainly the neck and the lower third of the face. The indication of facial allotransplantation remains rare in the burn patient. The deep carbonisation and the very extensive burn patient with severe functional sequelae where the standard reconstructive procedures are inefficient might be eligible for a facial allotransplant program.