Reconstruction of the Oral Commissure After an Electrical Burn

Facial injuries are extremely common due to increased incidence of vehicular and industrial trauma and warfare injuries. But isolated injury to the face due to low voltage cells exploding is rare. In blast injury, the force can cause massive soft tissue injury, along with injury to facial fractures and damage to adnexa. Facial injury is not life threatening unless associated with other injuries of the skull and airway. The major risks to airway in facial trauma are due to anatomic alteration of patient's airway through bony and soft tissue disruption and increased chances of aspiration. The past several decades have seen a rapid growth in the range of procedures available for reconstructive purposes. However, the essential preliminary management is a must and needs to be structured. The patient, a 10-year-old boy, was joining three pencil batteries in series and twisting the wire with his teeth when one battery exploded causing severe injuries to midface and mandibular region. After stabilization, the patient was taken up for surgery. A cap splint with zygomatic suspension was done for the maxilla, and wiring of residual mandibular segments with lining and skin cover provided by a deltopectoral flap was done. Reconstructive surgeries for reconstruction of the upper lip and maintenance of oral continence were planned for the future. The present case stresses the importance of educating the masses about unsafe handling of low voltage devices, management of airway, massive soft tissue injury, along with facial fractures and damage to adnexa.

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“…[7] The choice of procedure in these cases depends mainly on the likelihood of success, donor site morbidity, and potential for complication.…”

Section: Discussionmentioning

confidence: 99%

Blast injury face: An exemplified review of management

Kumar

Singh

Kumar

et al. 2013

Natl J Maxillofac Surg

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“…The plastic surgeon, when treating a patient with massive loss of soft tissue and bone of the face secondary to blast injury, must carefully consider available treatment options. [10] The choice of procedure should be dictated by the likelihood of success, donor site morbidity and Blast injury lower face the potential for complications. [11] We chose this up was lost because the young man was a tribal person procedure as we were familiar with head and neck probably on the move and he did not come back to our reconstructions using the PMMC and DP flaps.…”

Section: Discussionmentioning

confidence: 99%

Blast injury lower face: An unusual and rare case

Soni

2006

Indian J Plast Surg

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Isolated blast injuries of the face are rare and injuries due to blasting of low voltage batteries in or near the mouth are even rarer. We present here a case of an 18 year old boy who suffered from extensive injury and tissue loss involving the lower half of the face due to blasting of a low voltage battery used in a flash light due to apparent shortcircuiting when the boy put the two short wires connected to a low voltage battery in his mouth in order to deinsulate them. This resulted in a blast leading to severe injuries and tissue loss which included the lower nose, upper lip, all teeth, both cheeks, floor of mouth tongue, chin, the maxilla and mandible.

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“…23 Modifications of this technique include a separate orbicularis oris reconstructive layer and a ''Y to V'' oral musculomucosal advancement flap. 19,24 Although contracture and microstomia is an obvious concern, excellent aesthetic results may be achieved with secondary wound healing. Figure 7 and Fig.…”

Section: Special Considerations In Perioral Injury Repairsmentioning

confidence: 99%

Lip and Perioral Trauma

2010

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The management of perioral injuries is a complex topic that must take into consideration the unique anatomy, histology, and function of the lips to best restore form and function of the mouth after injury. Basic reconstructive principles include three-layered closure for full-thickness lip lacerations. Additionally, special care is needed to ensure an aesthetic repair of the cosmetically complex and important vermillion border, philtrum, and Cupid's bow. Infraorbital and mental nerve blocks provide lip anesthesia for laceration repair without distorting crucial aesthetic landmarks. Prophylactic antibiotics are usually indicated in perioral injuries due to wound contamination with saliva. Perioral burn management is controversial; however, most lip burns can first be managed conservatively. Splinting, plasties, and other reconstructive options are available after secondary healing of perioral burns. Hypertrophic scars are common in the perioral area after trauma. The mainstays of treatment for hypertrophic scars on the lips are silicone elastomer sheeting and intralesional steroid injections. For large perioral defects, a myriad of reconstructive options are available, ranging from primary closure, cross-lip flaps, and local tissue transfer, to free tissue transfers such as radial forearm free flaps, innervated gracilis free flaps, anterolateral thigh free flaps, and osteocutaneous free flaps.

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Reconstruction of the Oral Commissure After an Electrical Burn

Cited by 30 publications

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Blast injury face: An exemplified review of management

Blast injury face: An exemplified review of management

Blast injury lower face: An unusual and rare case

Lip and Perioral Trauma

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