Analyzing Local Flaps for Coverage of Facial Defects: A Retrospective Study

Chaudhary, Dinesh; Soni, Ashutosh; Agarwal, Sanjeev; Kumawat, J. L.

doi:10.9734/bpi/rdmmr/v10/5005f

“…However, it can be widened depending on its severity. If the debridement is too much, it can leave gaping wounds, cause tissue necrosis, or lead to dehiscence due to excessive tension [5,8,[11][12][13][14][15]. These are thought to become more severe as the severity of CFL increases.…”

Section: Discussionmentioning

confidence: 99%

“…Because each patient has a different shape and severity of CFL, it is important to tailor the pre-excisional design for debridement to each CFL case before performing surgical debridement [5,[10][11][12][13][14][15]. In TSD, the area to be excised is custom-made and designed before debridement is performed [13,14].…”

Section: Discussionmentioning

confidence: 99%

“…Because each patient has a different face shape and size and has a different shape and severity of CFL, it is important to tailor the customized pre-excisional design [tailored surgical debridement (TSD)] for each CFL case before performing surgical debridement [5,[9][10][11][12][13][14]. In TSD, the area to be excised is delineated using a skin marker pen to obtain the best results before excisional debridement is performed.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Tailored versus conventional surgical debridement in complex facial lacerations: a retrospective study

Park

¹

,

Min

²

,

Park

³

et al. 2023

Preprint

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Background Surgical debridement is usually an essential step in treating complex facial lacerations (CFL). As the severity of CFL increases, conventional surgical debridement (CSD) of wound edges becomes difficult and may be insufficient to remove damaged tissues and create clean edges. Because the severity and shape of CFL are diverse and different, it is necessary to tailor the customized pre-excisional design, the tailored surgical debridement (TSD), for each case before performing surgical debridement. Applying TSD is expected to enable effective debridement in CFL with higher severity. This study compared cosmetic outcomes and complication incidence of CSD and TSD, according to CFL severity. Methods This was a retrospective observational study. Eligible patients with CFL who visited the emergency department between August 2020 and December 2021 were examined. CFL severity was graded to Grades I and II. CSD and TSD outcomes were compared using the Scar Cosmesis Assessment and Rating (SCAR) scale. Furthermore, a good cosmetic outcome was defined as a SCAR score of ≤ 2. The percentage of good cosmetic outcome between the two groups was compared. The SCAR score and percentage of good cosmetic outcomes between the two groups were compared overall and by severity. For comparison of complication incidence, asymmetry, infection, and dehiscence incidence were compared. Results In total, 252 patients were enrolled (121 [48.0%] CSD and 131 [52.0%] TSD). In CSD and TSD groups, the median SCAR scores were 3 (1–5) and 1 (0–2) in all enrolled patients (p < 0.001), 2 (0–4) and 1 (0–1) in Grade I (p < 0.01), and 5 (4–6) and 1 (1–2) in Grade II (p < 0.001). The good cosmetic outcomes were 46.3% and 84.0% overall (p < 0.001), 59.6% and 85.0% in Grade I (p < 0.01), and 9.4% and 83.5% in Grade II (p < 0.001) for CSD and TSD. The incidence of complications was significantly higher in the CSD than in the TSD groups, but this was limited to asymmetry. There was no statistical difference in both infection and dehiscence. Conclusion TSD can lead to an objectively good cosmetic prognosis at higher CFL severity than CSD and can reduce the occurrence of facial asymmetry.

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“…If the debridement is too much, it can leave gaping wounds, cause tissue necrosis, or lead to dehiscence due to excessive tension. [5,8,[11][12][13][14][15] These are thought to become more severe as the severity of CFL increases. Therefore, debridement for CFL needs planning before excision in terms of using TSD based on individual CFL cases, with the goal of safer surgeries and more favorable outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…[5,7,8] Given the different shape and size of the face and the different shape and severity of CFL across patients, customized pre-excisional designs (tailored surgical debridement [TSD]) should be tailored according to each CFL case before performing surgical debridement. [5,[9][10][11][12][13][14] In TSD, the area to be excised is delineated using a skin marker pen before excisional debridement is performed, to obtain the best results. TSD can effectively remove almost all damaged tissues and create clean and simplified wound edges.…”

Section: Introductionmentioning

confidence: 99%

Tailored versus conventional surgical debridement in complex facial lacerations in emergency department: A retrospective study

Park

¹

,

Min

²

,

Park

³

et al. 2023

Medicine

0

View full text Add to dashboard Cite

Surgical debridement is an essential step in treating complex facial lacerations (CFL). As the CFL severity increases, conventional surgical debridement (CSD) of wound edges becomes difficult and may be insufficient. Because the severity and shape of each CFL vary, it is necessary to tailor the customized pre-excisional design, that is, tailored surgical debridement (TSD), for each case before performing surgical debridement. The use of TSD can enable effective debridement of CFL with higher severity. This study aimed to compare the cosmetic outcomes and complication incidence of CSD versus TSD according to CFL severity. In this retrospective observational study, eligible patients with CFL who visited the emergency department between August 2020 and December 2021 were examined. CFL severity was graded as Grades I and II. The outcomes of CSD and TSD were compared using the scar cosmesis assessment and rating (SCAR) scale, wherein a good cosmetic outcome was defined as a SCAR score of ≤ 2. The percentage of good cosmetic outcomes between the 2 groups was compared. The SCAR score and percentage of good cosmetic outcomes between the 2 groups were compared overall and by severity. For analyzing complication incidence, asymmetry, infection, and dehiscence incidence were compared. In total, 252 patients were enrolled [121 (48.0%) CSD and 131 (52.0%) TSD]. The median SCAR scores were 3 (1-5) and 1 (0-2) in all enrolled patients (P < .001), 2 (0-4), and 1 (0-1) in Grade I patients (P < .01), and 5 (4-6) and 1 (1-2) in Grade II patients (P < .001) in the CSD and TSD groups, respectively. The percentage of good cosmetic outcomes was 46.3% and 84.0% overall (P < .001), 59.6% and 85.0% in Grade I patients (P < .01), and 9.4% and 83.5% in Grade II patients (P < .001) in the CSD and TSD groups, respectively. The incidence of complications was significantly higher in the CSD group than in the TSD group, but this was limited to asymmetry. No significant difference was noted in infection or dehiscence. Compared with CSD, TSD can lead to an objectively good cosmetic prognosis at higher CFL severity and can reduce facial asymmetry occurrence.

show abstract

Tailored versus conventional surgical debridement in complex facial lacerations in emergency department: a retrospective study

Park

¹

,

Min

²

,

Park

³

et al. 2023

Preprint

0

View full text Add to dashboard Cite

Background Surgical debridement is usually an essential step in treating complex facial lacerations (CFL). As the severity of CFL increases, conventional surgical debridement (CSD) of wound edges becomes difficult and may be insufficient to remove damaged tissues and create clean edges. Because the severity and shape of CFL are diverse and different, it is necessary to tailor the customized pre-excisional design, the tailored surgical debridement (TSD), for each case before performing surgical debridement. Applying TSD is expected to enable effective debridement in CFL with higher severity. This study compared cosmetic outcomes and complication incidence of CSD and TSD, according to CFL severity. Methods This was a retrospective observational study. Eligible patients with CFL who visited the emergency department between August 2020 and December 2021 were examined. CFL severity was graded to Grades I and II. CSD and TSD outcomes were compared using the Scar Cosmesis Assessment and Rating (SCAR) scale. Furthermore, a good cosmetic outcome was defined as a SCAR score of ≤ 2. The percentage of good cosmetic outcome between the two groups was compared. The SCAR score and percentage of good cosmetic outcomes between the two groups were compared overall and by severity. For comparison of complication incidence, asymmetry, infection, and dehiscence incidence were compared. Results In total, 252 patients were enrolled (121 [48.0%] CSD and 131 [52.0%] TSD). In CSD and TSD groups, the median SCAR scores were 3 (1–5) and 1 (0–2) in all enrolled patients (p < 0.001), 2 (0–4) and 1 (0–1) in Grade I (p < 0.01), and 5 (4–6) and 1 (1–2) in Grade II (p < 0.001). The good cosmetic outcomes were 46.3% and 84.0% overall (p < 0.001), 59.6% and 85.0% in Grade I (p < 0.01), and 9.4% and 83.5% in Grade II (p < 0.001) for CSD and TSD. The incidence of complications was significantly higher in the CSD than in the TSD groups, but this was limited to asymmetry. There was no statistical difference in both infection and dehiscence. Conclusion TSD can lead to an objectively good cosmetic prognosis at higher CFL severity than CSD and can reduce the occurrence of facial asymmetry.

show abstract

Analyzing Local Flaps for Coverage of Facial Defects: A Retrospective Study

Cited by 3 publications

References 0 publications

Tailored versus conventional surgical debridement in complex facial lacerations: a retrospective study

Tailored versus conventional surgical debridement in complex facial lacerations: a retrospective study

Tailored versus conventional surgical debridement in complex facial lacerations in emergency department: A retrospective study

Tailored versus conventional surgical debridement in complex facial lacerations in emergency department: a retrospective study

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