MICROSURGERY IN WAR WOUNDS
By: LUIS EDUARDO BERMUDEZ R. MD. PLASTIC SURGEON.
CLINICAL CASE Nš 4.
HIGH VELOCITY GUNSHOT WOUND IN THE FACE
Picture 1. Severe damage of soft tissues in the lateral aspect of the face. Destruction of skin, parotid gland, facial nerve, mandible, and zygoma.
Picture 2. CT Scan shows the zygomatic arch and body destruction, mandible conminutive fracture with anterior displacement of the condile out of its place.
Picture 3. The zygoma body and zygomatic arch are reconstructed with a costal graft and AO microplates and screws. The mandible with an AO reconstruction plate from the condyle to the symphysis.
Picture 4. The soft tissue defect was reconstructed with a parascupular free flap. The facial nerve was reconstructed with sural nerve grafts.
Picture 5. The zygoma is in acceptable position.