SIMULTANEOUS PLASTIC SURGERY OF POST-BURN DEFECTS OF THE NASAL WING AND PHALANX OF THE FINGER
DOI:
https://doi.org/10.11603/2414-4533.2025.2.15395Keywords:
nose, burn, acid, defect, simultaneous reconstructionAbstract
The aim of the work: to assess the feasibility, optimal timing, and type of simultaneous plastic closure of post-burn defects of the nose and other parts of the body.
Materials and Methods. Between 2018 and 2021, three patients with chemical burns of the nose were admitted to the Lviv Regional Hospital for War Veterans and Repressed Persons named after Yuriy Lypa. Two men and one woman, aged (23±39) years, were treated. All burns were caused by sulfuric acid in household conditions. One patient, a 23-year-old woman, had a multifocal chemical burn on the nose, lower lip, and the third finger of the left hand.
Results. Upon examination of the defects of the lower lip and the area of the proximal interphalangeal joint, it was found that they were small and could heal by secondary tension without significant functional impairment. However, the burn of the tip and wing of the nose, as well as the area of the distal interphalangeal joint, required the use of plastic closure with flaps to achieve the best aesthetic and functional results. The closure of these defects was performed simultaneously using a surgical method under endotracheal anaesthesia. The surgery lasted 1 hour and 20 minutes. After excising the necrotic eschar from the nose, a French flap technique was used for the defect along the nasolabial fold. The finger defect was closed with a full-thickness skin flap from the left inguinal area. To prevent accidental detachment of the skin flap, the II and III fingers were fixed to the skin with separate knot sutures. No postoperative complications occurred. The transplanted skin flaps (bridges) were cut off one month after surgery. The aesthetic result was satisfactory after 2 and 6 months post-surgery.
Conclusions. Simultaneous plastic surgeries have an advantage over staged operations when appropriate conditions are present. Acid burns lead to the formation of dense coagulative necrosis. Plastic surgery for defect closure should be performed before the onset of tissue suppuration under the eschar.
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