Baeza RH, Favela CMR, Fernández RR, Santander FSA, Paz MR, López GPA, Padilla VF, Flores MA

Language: Spanish
References: 13
Page: 131-135
PDF size: 291.16 Kb.

ABSTRACT

Facial cutaneous necrosis is an uncommon condition, described in cases of mucormycosis, iatrogenic infiltration of hyaluronic acid, facial surgical procedures and necrosis due to cocaine use. We describe a case of facial and palpebral cutaneous necrosis secondary to necrotizing fasciitis and its microsurgical management in a 50-year-old male with a history of diabetes mellitus type 2, with frontal region trauma, that evolved to complete necrosis of the skin of the forehead and both eyelids. In the first surgery, debridement of necrotic sore was performed, in the second surgery anterolateral free flap of the right thigh, anastomosed to the facial artery with saphenous graft and to the facial vein. In the third stage surgery, inferior palpebral reconstruction was performed with total thickness skin grafts. In a follow-up period of two months, complete integration of grafts and flap was found, with partial recovery of eyelid mobility. The timely identification of facial skin necrosis may reduce sequelae. Although the clinical presentation was not the typical one, an early treatment and final reconstruction with anterolateral thigh flap was carried out, which continues to be a reconstructive option that can be used, offering a recovery of cutaneous integrity and improving patient social interaction.

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