HSC Section 3 - Trauma, Critical Care and Sleep Medicine

Wong et al

Fig. 3. ( A ) Severe microstomia 2 months following a lightbulb injury to the mouth and intraoral cavity. Pa- tient is unable to eat solid foods or maintain dental hygiene. ( B ) Release with intraoral mucosal flaps. Commissure splint fabricated intraoperative by oral surgeon. ( C ) 15-month follow-up with oral compe- tence and functioning orbicularis oris. Patient is able to pucker.

Free flaps have also been used with great suc- cess because they have the advantage of providing pliable tissue from a donor site away from the burn injury with minimal donor site morbidity. This has resulted in good neck mobility and contour without the need for prolonged post- operative splinting and a low contracture recur- rence rate. 37 This technique is especially useful in patients in whom follow-up compliance with neck splinting is limited (eg, Third World recon- structions during medical mission trips).

normal surrounding tissue needed for creation of local flaps. Recreation of the auricle to support eyeglass usage is a common goal in ear recon- struction following burn injury. 32 Reconstruction of both the cartilaginous frame- work and the soft tissue coverage are necessary following burn injury of the ear. Autologous costal chondral grafts are often used for ear reconstruc- tion but are tedious to carve and are associated with donor site morbidity. A porous polyethylene implant has become popular in reconstructing congenital ear defects and can also be used in burn reconstruction. This prefabricated porous implant allows for vascular and tissue ingrowth and resists warping without added donor site morbidity. Once the framework is in place, various

Ear Reconstruction

Burn reconstruction of the ear to restore partial or total ear loss is often limited by the absence of

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