ABSTRACT
Burns can be devastating and result in unwanted consequences with prolonged length of hospital stay. The mortality rate increases as the total body surface area increases, so proper management of patients with extensive degrees of burns is crucial for their survival. We present the hospital course, management, and survival of a patient after he sustained a 95% total body surface area, second-degree burn from a gas flame. Furthermore, we present from the literature different cases of patients with large total body surface area burns and survived after being managed in burns specialty centers. Although large total body surface area burns can result in significant morbidity and mortality, early management and intervention by an expert surgical team can result in positive outcomes.
ABSTRACT
OBJECTIVE: To evaluate the various methods and outcomes of post-traumatic partial auricle wound reconstruction, and to review the benefit to the patient's quality of life and their psychological improvement after the operation. METHODS: The prospective study included patients who suffered from post-traumatic partial auricular wounds. The defects were repaired using various techniques including simple local cutaneous advancement flaps, tube flaps, cartilage framework using conchal and costal cartilage with local skin flap cover. RESULTS: A total of 18 patients were included, with a male predominance (sex ratio: 7:2), mean age with standard deviation of 31.66 ±9.27 years. Causes included road traffic accident (RTA), assault, human and insect bite and avulsion injuries. Injuries were sustained in the upper third of the auricle (n=8); middle third (n=5), lower third (n=3), and upper two-thirds (n=2). Out of the 18 patients, wound were repaired using post auricular mastoid skin flap (n=7); local superior and inferior chondrocutaneous flap (n=3); costal cartilage as a cartilage framework (n=4), temporoparietal fascia used to cover the costal cartilage graft (n=1), and conchal cartilage as a cartilage framework (n=3). In our study 13/18 patients were 'highly satisfied' with the aesthetic outcome, 3/18 were 'moderately satisfied', and 2/18 were 'slightly satisfied'. None were dissatisfied by the postoperative result. In terms of objective assessment, patient outcome in two patients was graded 'good' while the outcome of remaining patients (n=16) was graded as 'excellent'. CONCLUSIONS: The use of skin flaps in the post-auricular region and the mastoid region associated with or without cartilage framework yields good cosmetic and functional result. The various techniques used for ear reconstruction yielded 100% satisfactory results in terms of functional outcome as well as boosting the confidence of patients.
