工作機械によるきょう部全層欠損 Ｄ‐Ｐ皮弁，前頭島状皮弁による再建の１例

Abstract

Nowadays, facial trauma is getting much more complicated and severed along with the social factors.Progress in surgical, anesthetical and medical ambulatory care has made it possible to save severely injured patients. Such life-threatening forces also cause severe facial trauma and cases needing more complex treatment plans arc increasing.In this paper, a case of a 44 year old male treated with multiple reconstructive procedures is presented.The patient was caught in to an iron-work machine by his left forearm and had an abulsed right malar area. After first aid for life was given, he was transfered to our department. The extent of injury was confirmed to be a rt. cheek full-thichness defect, partial loss and fractures of maxilla and mandible, multiple facial lacerations and burns through the first operation included wound debridement and primary maxillary and mandiblar reduction and fixation.One month later, the facial defect settled to 6 × 9 cm and segmental loss of rt. mandible was evident. D-P flap and forehead island flap reconstruction for cheek defect, mandibular repair with Vitallium® cast splint and iliac bone graft, transposition of parotid duct to oropharynx were performed.Through 4 separate operations over 20 hours, good functional and cosmetic reconstruction was aquired.