Cranial Maxillofac Trauma Reconstruction 2019; 12(01): 075-080
DOI: 10.1055/s-0038-1668511
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Short Runs for a Long Slide: Principalization in Complex Facial Restoration after Acid Attack Burn Injury

Christopher D. Hughes
1  Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts
2  Division of Plastic, Reconstructive and Laser Surgery, Shriners Hospitals for Children Boston, Boston, Massachusetts
,
Robert Jaroslaw Dabek
1  Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts
,
Johanna N. Riesel
1  Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts
,
Nemanja Baletic
1  Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts
,
James Chodosh
3  Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
,
Branko Bojovic
1  Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, Massachusetts
2  Division of Plastic, Reconstructive and Laser Surgery, Shriners Hospitals for Children Boston, Boston, Massachusetts
› Author Affiliations
Further Information

Publication History

09 April 2018

03 July 2018

Publication Date:
03 August 2018 (online)

Abstract

Burn injuries are responsible for a significant portion of surgically treatable morbidity throughout the world and particularly in underdeveloped and developing countries. Intentional flame, chemical, and contact burns are unfortunately a common mechanism of injury. It is estimated that intentional chemical burns are responsible for between 2 and 20% of burn injuries seen at burn centers in lower income countries. Women are commonly targeted and the perpetrators are often known to the victims. The combination of a high disease prevalence, limited surgical and anesthetic resources, a vulnerable patient population, and largely disfiguring, nonlethal injuries present unique challenges for the reconstructive surgeon who may not encounter such cases regularly. In this article, we present a case of a 16-year-old female who sustained severe, full-thickness burns to the face including eyelids, neck, abdomen, and upper extremities after an intentional acid attack. She began her treatment course with us approximately 1 year after the injury. The deformities of her oral and periorbital regions presented particularly difficult reconstructive problems, including impending visual loss. Using plastic surgical principalization, we provided our patient adequate restoration of facial form and function through numbers of interventions using fundamental and state-of-the-art techniques.