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Innovative technique creates large skin flaps for full-face resurfacing
Date:2/5/2014

solutionare used to enlarge the skin flap over time. While skin expansion is a standard technique for creation of skin flaps, Dr. Li and his team used an "overexpansion" approach to create very large flaps of relatively thin skinideal for use in the facial area. In some cases, when the skin flap was growing too thin, stem cells derived from the patients' own bone marrow were used as an aid to tissue expansion.

Using this technique, Dr. Li and colleagues were able to create very large skin flapsup to 30 30 cmfor use in full-face resurfacing. In the new article, they describe their use of their prefabrication/overexpansion technique in five patients with complete loss of the facial skin, caused by flame or chemical burns. All patients had previously undergone facial reconstruction, but were left with severe deformity and limited facial movement.

The "monoblock" allowed the surgeons to perform complete facial resurfacing using a single flap of the patient's own skin. The large flap size avoided problems with a "patchwork" appearance, while the thin flap width was well-suited for reconstruction of the facial features.

Multiple surgeries were needed to refine the results and to manage complications. However, all five patients eventually achieved a more normal appearance and better functioningincluding improved emotional expression.

The researchers emphasize that their patients with massive facial burns, while severely disfigured, differ from those with deeper tissue destruction who are candidates for face transplantation. Patients being considered for face transplantation have destruction not only of the skin and subcutaneous tissues, but also of the underlying facial muscles and organs of the head and neck.

Dr. Li and coauthors believe their technique, although complex, provides a valuable new approach to reconstruction for patients with complete destruction of the facial skin. They conclude, "It is a reliable and an excell
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Contact: Connie Hughes
Connie.Hughes@wolterskluwer.com
646-674-6348
Wolters Kluwer Health
Source:Eurekalert

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