Bifurcated Superficial Temporal Artery Island Flap for the Reconstruction of a Periorbital Burn: An Innovation

Abstract

Background:Facial burns represent between one-fourth and one-third of all burns. The long-term sequelae of periorbital burns include significant ectropion and lagophthalmos as a result of secondary burn contractures in the lower and upper eyelids, in addition to complete or incomplete alopecia of the eyebrows.Methods:A retrospective study of 14 reconstructive procedures for 12 postburn faces was conducted with all procedures performed since 2010 at the Department of Plastic Surgery, Al-Hussein University Hospital, and at the Craniofacial Unit, Nasser Institute Hospital. Four patients experienced chemical burns, and 8 patients experienced thermal burns. All patients underwent periorbital reconstruction using a bifurcated superficial temporal artery island flap to reconstruct the eyebrows, correct the lagophthalmos, and release the ectropion in both the upper and the lower eyelids. Two patients underwent bilateral periorbital flap reconstruction. The mean age of patients was 29 years, and the study was conducted on 8 males and 4 females. Patient satisfaction was assessed using a questionnaire completed by all patients postoperatively.Results:The complete release of both the upper and the lower eyelids was achieved in all cases, together with ideal replacement of brow hair; no complications were noted, apart from one case in which a loss of hair density in the new eyebrow was observed, combined with the partial loss of the flap in the lower eyelid. Patient satisfaction results were collected and assembled in a table.Conclusion:A bifurcated superficial temporal artery island flap is an innovative flap for reconstructing both burned eyebrows and eyelids.

Superficial temporal artery flap for reconstruction of complex facial defects: A new algorithm

“…This group included 13 cases of post-burn combined alopecia in the eyebrow and contracture of the lower eyelid; both defects were reconstructed with a bifurcated superficial temporal artery island flap, which was innovated by the corresponding author [ 7 ]. All patients satisfied the same criteria for periorbital reconstruction using a bifurcated superficial temporal artery island flap to reconstruct the eyebrows and to release ectropion in their upper and lower eyelids.…”

“…The goals of reconstruction in such cases should be to preserve, restore, and maintain function and appearance so that the cornea is protected from ulcers and painful conditions and the patient can return to his or her daily routine in society. To accomplish these goals, surgeons should employ an organized approach to restoring the burned periorbital area, including contracture release with replacement using the uncontracted option and restoration of the hair in the eyebrows [ 7 ].…”

“…Incisions should be located away from the arterial course and on the anterior hair line. A wide tunnel is necessary to avoid congestion, and a small amount of scalp subgaleal dissection is needed to close the defect primarily [ 7 ].…”

Reconstruction of post burns facial contractures and deformities: an Indian perspective

“…21 The island flap including a reverse flow flap can provide an optimal result for the eyelid contracture with minimal donor site morbidities. 22 Nasal reconstruction is usually based on the residual functional and aesthetic problems. The forehead flap with or without expansion is usually used for reconstruction of non-graftable nasal.…”

Extended bifurcated superficial temporal artery island flap for the reconstruction of a periorbital burn: A case report

“…Bifurcated superficial temporal island flap (BSTIF) is an innovative flap for reconstructing both burned eyebrows and eyelids. [ 1 ] In some patients, the eyebrow may need to be advanced medially in a second stage with the same limitation were observed in the lower flap to reconstruct the medial part of the lower eyelid.…”