Journal article
Total Reconstruction of Lower Lip and Chin Following Firework Injury Using Composite Bilateral Radial Forearm-Fascia Lata Flaps: A Case Report
Eplasty, Vol.23, e5
01/19/2023
PMCID: PMC9912048
PMID: 36817361
Abstract
Background: Primary explosion injuries with fireworks can lead to devastating and geometrically complex facial traumas that present a challenge to the reconstructive surgeon. Our patient, a woman in her early thirties, was hit directly in her chin by a large artillery shell firework. This caused complete soft tissue loss of the lower lip and chin beyond the oral commissures, complicated further by a comminuted mandible fracture.
Methods: After external fixation, our patient underwent a 2-stage reconstruction with a novel composite flap arrangement. Soft tissue coverage and lip reconstruction were performed with opposing bilateral radial forearm free flaps. The outer flap constituted the soft tissue of the new chin and outer lower lip, whereas the inner flap composed the intraoral lining. In the second stage, portions of the inner upper lip mucosa and superior orbicularis oris muscle were flipped down as a bipedicle, axial pattern "bucket-handle" type flap to the lower lip to reconstruct the vermilion. A graft of fascia lata was attached to the modioli of the orbicularis oris and interpositioned beneath the vermilion flap and the radial forearms to restore static and some dynamic sphincter control. One month later, the mandibular fractures underwent open reduction and internal fixation.
Results: Two months after soft tissue reconstruction with no complications, our patient had satisfactory aesthetic outcomes, oral competence, and speech.
Conclusions: This case has shown that use of bilateral, fascia lata-reinforced radial forearm flaps may be an effective choice for soft tissue reconstruction and oral competence restoration in cases of severe facial explosion trauma.
Details
- Title: Subtitle
- Total Reconstruction of Lower Lip and Chin Following Firework Injury Using Composite Bilateral Radial Forearm-Fascia Lata Flaps: A Case Report
- Creators
- Michael M Talanker - The University of Texas Health Science Center at HoustonKasra N Fallah - The University of Texas Health Science Center at HoustonCassie A Hartline - The University of Texas Health Science Center at HoustonDaniel J Freet - The University of Texas Health Science Center at Houston
- Resource Type
- Journal article
- Publication Details
- Eplasty, Vol.23, e5
- Publisher
- HMP Global
- PMID
- 36817361
- PMCID
- PMC9912048
- ISSN
- 1937-5719
- eISSN
- 1937-5719
- Language
- English
- Date published
- 01/19/2023
- Academic Unit
- Surgery
- Record Identifier
- 9984823101402771
Metrics
2 Record Views