Reconstruction of Facial Gunshot Wound by the Cervicopectoral Flap

Abstract

Background: Reconstruction of large facial defects secondary to shotgun blast to the face is a very difficult task in surgery. Case Study: We report on a 34-year-old female patient with suicidal shotgun injury to her face delivered by a hunting rifle at close range into her mouth. She showed a large right cheek defect and a mandibular fracture. The defect was closed by a cervicopectoral fasciocutaneous flap; the mandibular fracture was managed with a titanium reconstruction plate. Good aesthetic and functional results were achieved 1 year after reconstruction. Conclusion: Early definitive reconstruction of shotgun injuries is still controversial. The cervicopectoral flap has many advantages. It is easy and secure to harvest and possesses skin properties similar to the face. The flap is quite thin allowing soft tissue coverage without a bulky view. This is the first study in the literature using a cervicopectoral flap for closure of a facial gunshot wound. We conclude that in patients with facial gunshot wounds, early reconstruction with a cervicopectoral flap offers a very important alternative.