Prepatterned, sculpted free flaps for facial burns

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1 Scopus citations

Abstract

The demands of the twenty-first century dictate aesthetic excellence as well as functional correction in complex burn reconstructions. The severely disfigured burned face is marred by corrugated external scarring, distortion of facial features, and restricted facial movement. Z-plasties, local flaps, and full thickness skin grafts are useful in addressing more limited functional needs of ectropion release, nasal stenosis, perioral contractures, exposed ear cartilage, etc. [1]. However, in burns involving large surface areas of the face, these more limited applications are inadequate. Feldman has suggested megaunits of thick split-thickness skin grafts to cover large aesthetic units [2] (Fig. 44.1). Even in the most optimal circumstance, these will never simulate normal skin perfectly [3]. In my experience, large sheet grafts generate flat facies lacking texture, distinct facial planes, and facial expression, not to mention gross color mismatches.

Original languageEnglish
Title of host publicationColor Atlas of Burn Reconstructive Surgery
PublisherSpringer Berlin Heidelberg
Pages398-407
Number of pages10
ISBN (Print)9783642050695
DOIs
StatePublished - 2010

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