Two-stage reconstruction of a massive gun-shot wound of the midface with a free radial forearm flap and a parietal osteofasciocutaneous flap

Abstract

Treatment of midface gunshot injuries and their reconstruction remains one of the difficult problems of reconstructive surgery. Several flaps have been described for the reconstruction of total lip and nasal defects. We present a case of a gunshot wound to the midface in which a two-stage procedure was performed. In the first stage, a free radial forearm flap was successfully transferred for the reconstruction of the total nose. In the second stage, total upper lip reconstruction was achieved using a parietal osteofasciocutaneous flap pedicled to the parietotemporal fascia based on the superficialis temporal artery. At a mean follow-up period of 18 months, near-normal functional and cosmetic results were obtained. © Springer-Verlag 2004.