Microsurgical Replantation of Facial Composite Tissue

ABSTRACT

Background: Although microsurgical replantation is an established procedure for treating avulsion or amputation of unique head parts including scalp,¹ eyelid, nose,² ear,³ lip⁴ and tongue,⁵ there is currently no report of microsurgical replantation of substitutable facial tissues in the literature. In this report, the author presents a patient with avulsed facial composite tissue who was treated by replantation.

Methods: A 56-year-old man presented with avulsion of the left frontotemporal composite soft tissue after a traffic accident. The injury resulted in a defect measuring 6 x 8 cm and a few minor wounds on the left orbitofrontal area. The avulsed tissue was attached to the lateral orbital area by a narrow skin bridge with a width of about 0.3 cm. This connection, however, did not provide any blood flow to the avulsed tissue. Intraoperative exploration of the avulsed tissue revealed some available vessels in the wound margin, which were anastomosed in end-to-end manner to the corresponding vessels using 10-0 nylon sutures.

Results: The replanted composite tissue survived completely. The result 32 months after the operation was excellent both in aesthetic and functional terms.

Conclusions: The present case shows that microsurgical replantation of small composite tissues of the face is feasible. The author suggests that the indication spectrum for microsurgical replantation should be expanded beyond current clinical practice.

 

REFERENCES

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