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Titolo:
AESTHETIC RESTORATION OF THE SEVERELY DISFIGURED FACE IN BURN VICTIMS- A COMPREHENSIVE STRATEGY
Autore:
ROSE EH;
Indirizzi:
895 PK AVE NEW YORK NY 10121 MT SINAI MED CTR NEW YORK NY 10029
Titolo Testata:
Plastic and reconstructive surgery
fascicolo: 7, volume: 96, anno: 1995,
pagine: 1573 - 1585
SICI:
0032-1052(1995)96:7<1573:AROTSD>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
MICROVASCULAR FREE FLAPS; FREE TISSUE TRANSFER; FASCIAL FLAP; RECONSTRUCTION; EXPERIENCE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
38
Recensione:
Indirizzi per estratti:
Citazione:
E.H. Rose, "AESTHETIC RESTORATION OF THE SEVERELY DISFIGURED FACE IN BURN VICTIMS- A COMPREHENSIVE STRATEGY", Plastic and reconstructive surgery, 96(7), 1995, pp. 1573-1585

Abstract

Although highly specialized burn centers have significantly reduced mortality rates following extensive total body surface area burns, survivors are often left with grotesque facial disfigurement. The strategyof modern facial restoration emphasizes enhancement of aesthetic appearance as significantly as mitigation of functional impairment. Criteria for success are (1) an undistracted ''normal'' look at conversational distance, (2) facial balance and symmetry, (3) distinct aesthetic units fused by inconspicuous scars, (4) ''doughy'' skin texture appropriate for corrective makeup, and (5) dynamic facial expression. Since 1985, the author has successfully restored 17 severely disfigured burned faces by replacement of entire aesthetic units with microvascular ''prepatterned'' composite flaps blended into the facial canvas by cosmetic camouflage techniques. The series includes hemiface (2), neck/jaw (5), chin/lower lip (3), cheek/malar (5), peri orbital (2), nose (3), upper lip (4), and ear reconstructions (4). Flaps represented are freepreauricular (1), radial forearm (6), ulnar forearm (1), free scapular (6), ilio-ostcocutaneous (2), temporoparietal (8), vascularized forehead island (3), supraclavicular (1), and SMAS (1). Important to outcome is extensive initial intraoperative ''sculpting'' to simulate normal planes and contours. Seams are placed at junctions of facial components. Three-dimensional imaging is used to assess architectural asymmetries, and bone grafts are aided by computer-generated acrylic models. Adjunctive procedures include tensor fasciae latae slings, intraoperative tissue expansion, suction-assisted lipectomy, and scar management. After restoration of facial form and texture, flesh color make-up and/or tattooing of beard, lips, scars, eyebrows, etc., aid to hide scarsand pigment the skin to harmonize with the rest of the face. In all cases, facial integrity has been aesthetically restored and, in most instances, with makeup, is near normal in social settings at conversational distances. Facial animation is retained and color matches are excellent. One flap was lost early in the series.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/09/20 alle ore 05:46:50