Should We Consider Preparing Patients for Future Face Transplant when Managing Complex Facial Trauma?

Area of Science:

• Reconstructive Surgery
• Microsurgery
• Transplantation

Background:

• Face transplantation is an emerging procedure for severe facial defects.
• Optimal outcomes require meticulous pre-transplant preparation of the maxillofacial skeleton and soft tissues.

Purpose of the Study:

• To present a case of pre-transplant reconstructive surgery for a patient with extensive craniomaxillofacial trauma.
• To highlight the importance of this preparation for successful face transplantation.

Main Methods:

• Open reduction internal fixation of complex facial fractures (LeFort III, zygomaticomaxillary complex, maxilla, mandible).
• Reconstruction using titanium plates.
• Soft-tissue coverage with free anterolateral thigh perforator flaps and a fasciocutaneous flap.
• Management of flap complications including partial necrosis.

Main Results:

• Achieved stable bone reconstruction and soft-tissue coverage in a patient with severe ballistic facial injury.
• Patient was successfully discharged and subsequently underwent a face transplant.
• Demonstrated feasibility of complex pre-transplant reconstruction.

Conclusions:

• Pre-transplant reconstructive surgery is vital for patients with craniomaxillofacial trauma exceeding conventional limits.
• This approach enhances the potential for optimal face transplant outcomes.
• Minimizing flap donor site morbidity is a key consideration.