Massive craniofacial injury: initial treatment and methods of reconstruction

A patient with a massive craniofacial injury is presented to illustrate useful flaps that may be used in the reconstruction of this type of injury. Initial management, consisting of basic life support, is indicated, because many patients who appear to be unsalvageable may be successfully restored to an active, productive life. Reconstruction of soft-tissue deficits was accomplished using the forehead and deltopectoral flaps. Although other methods of reconstruction may be used, the forehead and deltopectoral flaps remain among the more reliable flaps to restore thin lining to mucosal and external skin surfaces where bulky tissues are not desired.