【摘 要】
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The case was 80-year-old woman.She was injured face, trunk, and upper limbs (TBSA 21%) by flame bum.She was operated seven times and closed all raw surface by skin grafting.She was moved and referred
【机 构】
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北里大学メディカルセンター 形成外科
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The case was 80-year-old woman.She was injured face, trunk, and upper limbs (TBSA 21%) by flame bum.She was operated seven times and closed all raw surface by skin grafting.She was moved and referred to our hospital.She wished to release the scar contracture of angle of mouth.But the face was split thickness skin.So We abandoned reconstruction with local flap.We have planned a pedicle flap with tissue expander inserting in the anterior chest.We excised the contracted scar tissue of the comers of the mouth region and we made the skin flap that pedicled from clavicle portion and adapted.Intermediate part was formed as a tube flap.Course was uneventful and separated three weeks later.The flap was taken almost.Opening range of mouth was also improved immediately after surgery, but that came back with each passing months.So we added Z-plasty in both comers of the mouth.Opening range was sufficient.Currently, she is creating a denture.I consider each comer of the mouth reconstruction when reconstruction in local flap is not possible.
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