Primary one-stage reconstruction of cheek defect after a shotgun blast to the face: Use of the latissimus dorsi musculocutaneous free flap for soft-tissue repair and facial reanimation
T. Safak et M. Akyurek, Primary one-stage reconstruction of cheek defect after a shotgun blast to the face: Use of the latissimus dorsi musculocutaneous free flap for soft-tissue repair and facial reanimation, ANN PL SURG, 47(4), 2001, pp. 438-441
The authors describe a, case of a shotgun blast injury to the face in which
early definitive repair of both facial soft tissues and facial reanimation
was accomplished in one stage using a free flap. The trauma occurred 2 day
s before presentation via a hunting rifle fired at a short range. On examin
ation, a 8 x 5-cm cheek defect was evident, involving the full thickness of
the perioral facial mimetic muscles as well. A free latissimus dorsi muscu
locutaneous flap was transferred to the defect, with the thoracodorsal nerv
e coapted to an ipsilateral, severed buccal branch of the facial nerve. Pos
toperatively, the flap survived completely, with its skin paddle excised su
bsequently in two stages. Good muscle movement was obtained, providing rest
ing symmetry and a pleasant smile. Other than soft-tissue and bony defects
resulting from shotgun injuries, ablation of the facial nerve or facial mim
etic muscles may be an; important component of the defect that needs furthe
r consideration. The authors conclude that the current technique of one-sta
ge, early definitive repair of soft tissues and facial reanimation in such
cases of facial shotgun blast injury offers the advantages of achieving bot
h goals with one flap and accomplishing the procedure primarily in one stag
e.