Aesthetic soft tissue management in facial trauma

Article information

J Korean Med Assoc. 2018;61(12):715-723

Publication date (electronic) : 2018 December 17

doi : https://doi.org/10.5124/jkma.2018.61.12.715

Kyu Jin Chung, MD , Tae Gon Kim, MD , Jin Ho Lee, MD

Department of Plastic & Reconstructive Surgery, Yeungnam University College of Medicine, Daegu, Korea

Corresponding author: Kyu Jin Chung E-mail: chungkj@ynu.ac.kr

Received 2018 November 21; Accepted 2018 December 05.

Abstract

Facial soft tissue injury due to trauma is common. Severe damage of soft tissue causes functional and cosmetic problems. In the initial evaluation of patients with facial trauma, airway maintenance and respiratory maintenance are the most important. The principles of treatment include adequate irrigation and debridement, primary closure, or secondary wound healing. Postoperative care such as taping, silicone gel sheeting, and sun screening is important to prevent scarring. The scalp and forehead are abundant in blood and can cause severe bleeding. The eyelid is very thin and has a multilayered structure, requiring accurate suturing and reconstruction of the layers. It is advisable to determine the presence of hematoma in the ear and treat it. When the cheek area is damaged, it is necessary to identify and treat the damage of the parotid gland and the facial nerve branch. The lips should be sewn with the white roll of lip and vermillion.

Keywords: Face; Wounds and injuries; Soft tissues; Therapy

References

1. Hollander JE, Singer AJ, Valentine S, Henry MC. Wound registry: development and validation. Ann Emerg Med 1995;25:675–685.

2. Visscher MO, Bailey JK, Hom DB. Scar treatment variations by skin type. Facial Plast Surg Clin North Am 2014;22:453–462.

3. Chadwick S, Heath R, Shah M. Abnormal pigmentation within cutaneous scars: a complication of wound healing. Indian J Plast Surg 2012;45:403–411.

4. Mithani SK, St-Hilaire H, Brooke BS, Smith IM, Bluebond-Langner R, Rodriguez ED. Predictable patterns of intracranial and cervical spine injury in craniomaxillofacial trauma: analysis of 4786 patients. Plast Reconstr Surg 2009;123:1293–1301.

5. Warren JW, Platt R, Thomas RJ, Rosner B, Kass EH. Antibiotic irrigation and catheter-associated urinary-tract infections. N Engl J Med 1978;299:570–573.

6. Collins JB, Mahabir RC, Potter JK. Facial soft tissue trauma. In : Janies JE, Good AL, Taylor SJ, eds. editors. Essentials of plastic surgery 2nd ed.th ed. Boca Raton: CRC Press; 2014. p. 315–322.

7. Hohenleutner U, Landthaler M. Effective delayed brush treatment of an extensive traumatic tattoo. Plast Reconstr Surg 2000;105:1897–1899.

8. Bohler K, Müller E, Huber-Spitzy V, Schuller-Petrovic S, Knobler R, Neumann R, Seidl K. Treatment of traumatic tattoos with various sterile brushes. J Am Acad Dermatol 1992;26:749–753.

9. Kretlow JD, McKnight AJ, Izaddoost SA. Facial soft tissue trauma. Semin Plast Surg 2010;24:348–356.

10. Atkinson JA, McKenna KT, Barnett AG, McGrath DJ, Rudd M. A randomized, controlled trial to determine the efficacy of paper tape in preventing hypertrophic scar formation in surgical incisions that traverse Langer's skin tension lines. Plast Reconstr Surg 2005;116:1648–1656.

11. de Giorgi V, Sestini S, Mannone F, Papi F, Alfaioli B, Gori A, Lotti T. The use of silicone gel in the treatment of fresh surgical scars: a randomized study. Clin Exp Dermatol 2009;34:688–693.

12. Kwak DH, Bae TH, Kim WS, Kim HK. Anti-vascular endothelial growth factor (Bevacizumab) therapy reduces hypertrophic scar formation in a rabbit ear wounding model. Arch Plast Surg 2016;43:491–497.

13. Oishi SN, Luce EA. The difficult scalp and skull wound. Clin Plast Surg 1995;22:51–59.

14. Khouri KS, Cardoso E, Khouri RK. Percutaneous mesh expansion: a regenerative wound closure alternative. Plast Reconstr Surg 2018;141:451–457.

15. Kim J, Hwang W. Forehead reconstruction using modified double-opposing rotation-advancement flaps for severe skin necrosis after filler injection. Arch Craniofac Surg 2018;19:64–67.

16. Lee JW, Park SH, Lee SJ, Kim SH, Jeong HS, Suh IS. New economical and simple device for intraoperative expansion on small and medium sized soft tissue defects. Arch Craniofac Surg 2018;19:235–239.

17. Park J, Yun S, Son D. Changes in eyebrow position and movement with aging. Arch Plast Surg 2017;44:65–71.

18. Kim YJ, Lee KH, Choi HL, Jeong EC. Cosmetic lateral canthoplasty: preserving the lateral canthal angle. Arch Plast Surg 2016;43:316–320.

19. Han JH, Kim J, Yoon KC, Shin HW. Treatment of posttraumatic hematoma and fibrosis using hyaluronidase injection. Arch Craniofac Surg 2018;19:218–221.

20. Lee SK, Lim YM, Lew DH, Song SY. Salvage of unilateral complete ear amputation with continuous local hyperbaric oxygen, platelet-rich plasma and polydeoxyribonucleotide without micro-revascularization. Arch Plast Surg 2017;44:554–558.

21. Sexton RP. Utilization of the amputated ear cartilage. Plast Reconstr Surg (1946) 1955;15:419–422.

22. Oh MJ, Kang SJ, Sun H. A Simple modified flip-flop flap for the reconstruction of antihelix and triangular fossa defects. Arch Plast Surg 2016;43:122–124.

23. Goldwyn RM, Rueckert F. The value of healing by secondary intention for sizeable defects of the face. Arch Surg 1977;112:285–292.

24. Park KS, Lee WS, Ji SY, Yang WS. The treatment of posttraumatic facial skin defect with artificial dermis. Arch Craniofac Surg 2018;19:35–40.

25. Lombardo GA, Tamburino S, Tracia L, Tarico MS, Perrotta RE. Lateral nasal artery perforator flaps: anatomic study and clinical applications. Arch Plast Surg 2016;43:77–83.

26. Lee DM, Bae YC, Nam SB, Bae SH, Choi JS. Reconstruction of large facial defects via excision of skin cancer using two or more regional flaps. Arch Plast Surg 2017;44:319–323.

27. Lee KS, Kim JO, Kim NG, Lee YJ, Park YJ, Kim JS. A comparison of the local flap and skin graft by location of face in reconstruction after resection of facial skin cancer. Arch Craniofac Surg 2017;18:255–260.

28. Jin HB, Yang JY, Kim KS, Kim SH, Choe J, Chung JH. Staged lower lip reconstruction following gangrenous stomatitis in an immunosuppressed patient. Arch Craniofac Surg 2018;19:222–226.

29. Borab Z, Mirmanesh MD, Gantz M, Cusano A, Pu LL. Systematic review of hyperbaric oxygen therapy for the treatment of radiation-induced skin necrosis. J Plast Reconstr Aesthet Surg 2017;70:529–538.

30. Eskes A, Vermeulen H, Lucas C, Ubbink DT. Hyperbaric oxygen therapy for treating acute surgical and traumatic wounds. Cochrane Database Syst Rev 2013;12:CD008059.

31. Greaves NS, Iqbal SA, Hodgkinson T, Morris J, Benatar B, Alonso-Rasgado T, Baguneid M, Bayat A. Skin substitute-assisted repair shows reduced dermal fibrosis in acute human wounds validated simultaneously by histology and optical coherence tomography. Wound Repair Regen 2015;23:483–494.

32. Chernoff G, Bryan N, Park AM. Mesothelial stem cells and stromal vascular fraction: use in functional disorders, wound healing, fat transfer, and other conditions. Facial Plast Surg Clin North Am 2018;26:487–501.

33. Lichtman MK, Otero-Vinas M, Falanga V. Transforming growth factor beta (TGF-β) isoforms in wound healing and fibrosis. Wound Repair Regen 2016;24:215–222.

34. Jeong W, Yang CE, Roh TS, Kim JH, Lee JH, Lee WJ. Scar prevention and enhanced wound healing induced by polydeoxyribonucleotide in a rat incisional wound-healing model. Int J Mol Sci 2017;18

35. Kim S, Kim J, Choi J, Jeong W, Kwon S. Polydeoxyribonucleotide improves peripheral tissue oxygenation and accelerates angiogenesis in diabetic foot ulcers. Arch Plast Surg 2017;44:482–489.

36. Sosin M, Rodriguez ED. The face transplantation update: 2016. Plast Reconstr Surg 2016;137:1841–1850.

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