Ebrahimi Ali, Kazemi Hossein Mohammad, Nejadsarvari Nasrin
Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
Department of Medical Ethics, Tehran University of Medical Sciences, Tehran, IR Iran.
Trauma Mon. 2014 Aug;19(3):e16220. doi: 10.5812/traumamon.16220. Epub 2014 Aug 1.
Facial soft tissue injury can be one of the most challenging cases presenting to the plastic surgeon. The life quality and self-esteem of the patients with facial injury may be compromised temporarily or permanently. Immediate reconstruction of most defects leads to better restoration of form and function as well as early rehabilitation.
The aim of this study was to present our experience in management of facial soft tissue injuries from different causes.
We prospectively studied patients treated by plastic surgeons from 2010 to 2012 suffering from different types of blunt or sharp (penetrating) facial soft tissue injuries to the different areas of the face. All soft tissue injuries were treated primarily. Photography from all patients before, during, and after surgical reconstruction was performed and the results were collected. We used early pulsed dye laser (PDL) post-operatively.
In our study, 63 patients including 18 (28.5%) women and 45 (71.5%) men aged 8-70 years (mean 47 years) underwent facial reconstruction due to soft tissue trauma in different parts of the face. Sharp wounds were seen in 15 (23%) patients and blunt trauma lacerations were seen in 52 (77%) patients. Overall, 65% of facial injuries were repaired primary and the remainder were reconstructed with local flaps or skin graft from adjacent tissues. Postoperative PDL therapy done two weeks following surgery for all scars yielded good results in our cases.
Analysis of the injury including location, size, and depth of penetration as well as presence of associated injuries can aid in the formulation of a proper surgical plan. We recommend PDL in the early post operation period (two weeks) after suture removal for better aesthetic results.
面部软组织损伤可能是整形外科医生面临的最具挑战性的病例之一。面部受伤患者的生活质量和自尊可能会受到暂时或永久的损害。大多数缺损的即刻重建可更好地恢复外形和功能，并实现早期康复。
本研究的目的是介绍我们在处理不同原因导致的面部软组织损伤方面的经验。
我们前瞻性地研究了2010年至2012年由整形外科医生治疗的、面部不同区域遭受不同类型钝性或锐性（穿透性）面部软组织损伤的患者。所有软组织损伤均进行了一期治疗。对所有患者在手术重建前、术中及术后进行了摄影，并收集了结果。术后我们使用了早期脉冲染料激光（PDL）。
在我们的研究中，63例患者（年龄8 - 70岁，平均47岁，其中18例（28.5%）为女性，45例（71.5%）为男性）因面部不同部位的软组织创伤接受了面部重建。15例（23%）患者为锐器伤，52例（77%）患者为钝性创伤撕裂伤。总体而言，65%的面部损伤进行了一期修复，其余的采用局部皮瓣或取自相邻组织的皮肤移植进行重建。在我们的病例中，术后两周对所有瘢痕进行的PDL治疗取得了良好效果。
对面部损伤的分析，包括损伤的位置、大小、穿透深度以及是否存在合并损伤，有助于制定合适的手术方案。我们建议在拆线后的术后早期（两周）使用PDL，以获得更好的美学效果。
