Abstract
Facial burns represent between one-fourth and one-third of all burns [1]. Deformities resulting from a totally burned face present as a profound challenge to the reconstructive plastic surgeon. Burns of the head and neck present a particularlycomplex problem, as they involve critical structures, important functionally and cosmetically; they are usually extensive, involving adjacent tissues, limiting reconstructive possibilities. Whether acute facial burns should be excised and grafted is still controversial [10]. Traditionally, skin grafting has been used for resurfacing but with limited success in case of damage of the deeper facial structures. When possible, loco-regional flaps are themethod of choice. When the burns are extensive, adequate amounts of reliable regional tissue are not available. The use of tissue expanders or expanded full-thickness skin grafts is another alternative [2,11,15]. Free tissue transfers and prelaminated flaps have revolutionized burn reconstruction. Angrigiani et al. reported a novel method for total face reconstruction using the bilateral extended scapular free flaps. The donor site morbidity is, however, relatively high with a large scar extending across the entire back and, moreover the nose needs separate reconstruction [3]. Fujiwara et al. [3] used a single large free flap resulting from expansion of the back skin for reconstruction of the entire face including the nose. However, free flaps
Published Version
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