Upper Lip Reconstruction Using Fujimori Gate Flap in an Electrical Burn Patient

The Fujimori gate flap has been known and used for reconstruction of defects resulting from oncologic surgery. In this case report, we describe how this flap was utilized in reconstructing the upper lip of a patient who experienced an electrical burn injury resulting in 70% tissue loss of the upper lip with exposed alveolar bone. A 22-year-old man presented to our institution with near total full-thickness burn over the upper lip, deep partial thickness burns over left upper lid, and superficial partial thickness burns over both malar areas, anterior chest, and both legs. He underwent full-thickness skin grafting of the left upper lid and upper cutaneous lip. After 3 weeks, a unilateral gate flap was performed. The flap was elevated with care to preserve the right angular artery and the Stensen's duct. The flap was rotated 90 degrees medially and was sutured to the contralateral orbicularis oris, gingivobuccal mucosa, and to the rest of the upper cutaneous lip. The patient was followed up at 6 months and 1 year postoperatively. The flap was able to restore oral competence and enabled the patient to speak and chew with no difficulty. Patients suffering from high-voltage electrical burns, especially involving the mouth, present a challenging case for surgeons for reconstruction. Here, the goals of the reconstruction are to restore oral competence and ability to articulate, and still provide good appearance. A feasible and aesthetically acceptable flap providing good functional outcome is provided by the use of the unilateral Fujimori gate flap among patients suffering from high-voltage electrical burns of the oral cavity.