Neale H W, Billmire D A, Carey J P
Clin Plast Surg. 1986 Jan;13(1):119-36.
Burn reconstruction of the head and neck must first start with special care to this anatomic area in the early acute phase, with appropriate early débridement and coverage with sheet grafts of medium thickness into unit facial orientation. Postoperative garment and mask splinting, will help lessen the hypertrophic scar formation that frequently follows facial burns and skin coverage. Carefully planned reconstruction of these areas is indicated, with priority given first to the neck, then to the periorbital area, and then to perioral areas. Principles of scalp, ear, nasal, and cheek reconstruction following burns of the face are carefully outlined. The unit concept of burn scar resurfacing of the face has been the mainstay of our treatment. We have emphasized skin coverage of the face from similar donor site areas. The emotional and psychological effects of facial scarring secondary to severe burns are crippling to patients. Although numerous reconstructive surgical procedures may lessen the deformity, ultimately burn patients realize that their burn scars are permanent and no surgeon can give them back their original facial appearance. These patients need strong and continued support and reassurance from their physicians and nursing professional staff to maintain their self-identity and confidence.
头颈部烧伤重建必须在急性早期就特别关注这一解剖区域，进行适当的早期清创，并采用中厚皮片按面部单位方向覆盖。术后使用弹力衣和面罩夹板，将有助于减少面部烧伤和皮肤覆盖后经常出现的增生性瘢痕形成。对这些区域进行精心规划的重建是必要的，优先顺序为颈部，然后是眶周区域，接着是口周区域。文中仔细概述了面部烧伤后头皮、耳、鼻和面颊重建的原则。面部烧伤瘢痕修复的单位概念一直是我们治疗的主要方法。我们强调从相似供区进行面部皮肤覆盖。严重烧伤导致的面部瘢痕所产生的情感和心理影响对患者来说是极具伤害性的。尽管众多重建手术可能会减轻畸形，但最终烧伤患者会意识到他们的烧伤瘢痕是永久性的，没有外科医生能让他们恢复原来的面部外观。这些患者需要医生和护理专业人员给予坚定且持续的支持和安慰，以维持他们的自我认同和信心。
