These are defects of the face and head result from trauma, can present as soft tissue and/or bony defects. They can present as acute defects soon after injury with or without concomitant life threatening injuries or as delayed presentation, weeks to months after injury. These defects result in cosmetic
disfigurement or functional problems or both. Common causes of craniofacial defects are Road traffic accidents, burns specially electric and chemical
burns, gunshot injuries, animal and human bites and assault. These defects range from loss of soft tissue or bone from any part of face and head like forehead, eyelids, nose, cheek, mouth, and amputation of nose, and ear, avulsion injury to skin and soft tissue of skull, non-healed wounds to healed area of soft tissue loss of any part of face and head. Management of these defects depends on their causes, time of presentation, condition of patient and wounds, site and size of defect and available treatment options. Life threatening injuries are common in this region like brain injury and are dealt in emergency meanwhile wounds are dealt with wound wash, dressings, antibiotics till patient condition allow for definitive management.
Amputation of nose and ear and total scalp avulsion and be can be dealt with reimplantation surgery of placing nose and ear back to their place by microvascular surgery if brought to hospital early and amputated part or tissue of scalp is in good condition. (See ear nose recon) Reconstruction of other defects require skin grafts, loco regional or free flaps (tissue transferred from other part of body along with its blood supply) bone and cartilage grafts, alloplastic materials and more than one surgeries are required for complex defects.
1. What are functional problems associated with facial defects
Problems of vision, eating, breathing, hearing can occur according to area involved
2. Will face look same as before trauma after plastic surgery
The purpose is to maintain form and function as much as possible. If injuries are severe ad
complex cosmetic outcome is reasonable but not best.
3. What are chances of success in facial defects
Chances of success are good I expert hands
4. Will there be scar after surgery
Scar is unavoidable after any surgery but with meticulous technique scar can be minimized.
5. What if nose and ear not reconstructed by surgery
Prosthesis (custom made nose and ears) can be used after detailed copulation with our plastic
surgeon
Outcome depends on the location and size of the fistula and status of surrounding tissues. Although most of the fistula closes after the surgery, some may recur and requires further surgery.
It usually takes less time than the original hypospadias repair and completes in less than an hour.
The surgery is performed under general anaesthesia and as a day care procedure. Patient can go home the same day after recovery from anaesthesia.
The most common complication is recurrence of the defect. Others complications include infection, difficulty in urination and stricture formation
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