EWMA 2013 - Ep581 - Consecutive reconstructive surgery of trunk, neck and face deformities after burn injury

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MD E. Zacharevskij1 , MD PhD V. Kaikaris1, MD PhD R. Rimdeika1, G. Samulėnas2

1Department of Plastic and Reconstructive Surgery, Hospital of Lithuanian University of Health Sciences 2Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences

Published in: Health & Medicine
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EWMA 2013 - Ep581 - Consecutive reconstructive surgery of trunk, neck and face deformities after burn injury

  1. 1. Consecutive reconstructive surgery of trunk, neck and face deformities after burn injury MD E. Zacharevskij1 , MD PhD V. Kaikaris1, MD PhD R. Rimdeika1, G. Samulėnas2 1Department of Plastic and Reconstructive Surgery, Hospital of Lithuanian University of Health Sciences 2Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences Introduction A 25 year old man at the age of fifteen was injured in a fire accident and underwent long hospital stay and several skin transfer operations. During the post injury period he suffered from residual skin contractures, located in the left armpit region, neck, face and microoris. Reconstructive operations schedule was composed for the patient considering main complains and major post burn contractures. •Firstly, scar excision and skin flap rotation was performed in the left armpit region in order to increase left hand elevation. •Next procedure was a combined microoris correction with infranasal region plasty and expander insertion. •After three months of expanding there was sufficient skin to cover right neck region after eliminating the neck contracture. In post-operative period patient underwent physiotherapy and scar reducing procedures. Discussion Burn survivors face a variety of chalenges, including physical, psychological and social aspects. The generic health status (SF-36 questionare) of a burn patient is significantly lower than general population scores.1 The Health Related Quality of Life (HRQoL) scores are worse in comparison with general population (respectively 0,839 ± 0,125 and 0,936 ± 0,071),and do not improve significantly during 2-year follow up2. Consecutive surgical approach could modify physical aspects and decrease dissatisfaction of body appearance, thus lowering chances of depression. We report a case of a successful multi-stage reconstruction of a burn injury, which included body areas of high importance concerning psychological and physical aspects. Case presentation Results, conclusions After two years of treatment patient has proper left hand elevation, neck rotation and microoris correction. Patients after deep skin burns need permanent supervision and an incentive to start treatment3. Well planed consecutive reconstructive surgery significantly improves life quality of burned patients. References 1.Moi, A.L., Wentzel-Larsen, T., Salemark, L., Wahl, A.K., Hanestad, B.R. Impaired generic health status but perception of good quality of life in survivors of burn injury. Journal of Trauma - Injury, Infection and Critical Care, Volume 61, Issue 4, October 2006, Pages 961- 968 2.Koljonen V, Laitila M, Sintonen H, Roine RP. Health-related quality of life of hospitalized patients with burns-comparison with general population and a 2-year follow-up. Burns. 2013 May;39(3):451-7 3.Rea SM, Goodwin-Walters A, Wood FM. Surgeons and scars: differences between patients and surgeons in the perceived requirement for reconstructive surgery following burn injury. Burns. 2006 May;32(3):276-83 Depression Physical function Age Body image dissatisfaction TBSA (%) burned Facial burn Female sex Before operation Expander insertion and filling stages

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