Strategies to Increase Flap Survival in Nasal Reconstruction in Patients With Deep Panfacial Burns

Abstract

Total nasal reconstruction requires the management of skin, cartilage, and nasal mucosa. This three-dimensional surgical approach is especially restricted in patients with severe deformities after deep panfacial burns. In this regard, the development of tissue fibrosis reduces the quality and reliability of surrounded donor sites, limiting the surgical options and flap survival outcomes. This report discusses the benefit of tissue protection procedures, such as flap delay and leech therapy, in the total nasal reconstruction of a patient with split-thickness skin grafts on donor sites for forehead and nasolabial flaps.

Nasal Reconstruction in Panfacial Burns

“…This is particularly the case when composite grafts are used for secondary reconstruction of alar defects in facial burns. 7 In our second case, we optimized composite graft take in a patient who had sustained deep dermal burns to the face after a house fire (Fig. 6 Our first patient sustained deep panfacial burns after a selfinf licted burn injury of greater than 70% total body surface area, which resulted in bilateral alar subunit loss (Fig.…”