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Deep facial chemical burn - emergency, assessment, management and reconstruction
Date Issued |
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2010-05-26 |
ntroduction: 39 years woman was admitted to emergency room with extensive face chemical burn as a result of assault. Plastic surgeon suggested strong acid effect as etiology of the burn because of coagulation necrosis signs. The affected zones where cleaned immediately with water shower for forty minutes period. Aim: We are presenting a case report of deep facial chemical burn management and face reconstruction. Methods: Laser Doppler scanning has been applied for burn depth assessment. The evaluation showed full thickness burns of nose, left cheek and left periorbicular area and partial thickness burns of other face parts. We applied early necrectomy and lid reconstruction for ektropion prevention and concomitant left eye drying. Consequent necrectomies and granulation tissue inducing dressings helped to prepare damaged area for further autodermoplasty. Partial thickness skin graft has been used for nose recovery. Results: We have avoided bacterial infection of the burned area using everyday dressings and face care. Lid reconstruction prevented left eye damaging. After one month hospitalization all burned area has been covered with skin. Grafting saved nose cartilages and restored configuration of the patient face. Conclusions: Strong chemical substances cause deep skin damages even if water debridement is applied immediately after accident. Early necrectomies reduce inflammation process and further scar formation. Deep facial chemical burn requires precise supervision and thorough management in special unit to get satisfactory results.