Type of publication:
Conference abstract
Author(s):
*Sandhu B.; *Messahel A.
Citation:
British Journal of Oral and Maxillofacial Surgery; Dec 2016; vol. 54 (no. 10)
Abstract:
Facial injuries can lead to extensive scarring, causing physical discomfort, anxiety and social isolation for patients. The optimum method of wound healing would be primary closure, however in cases where this is not possible other options must be explored. This case report involves a 40 year old female who sustained a severe scalp wound following a road traffic accident, causing partial ejection from the vehicle. The patient was transferred to our care seven days after receiving treatment to the affected area by an emergency department. Examination revealed an 8 cm right frontal scalp region wound present, which was clearly acutely infected with areas of full thickness skin necrosis and generalised overlying slough across the defect. The lower region of the wound involved an area of 2.5 cm exposed bone. There was also weakness noted of the temporal branch of the right facial nerve with reduced brow movement. Following thorough debridement and lavage, combination treatment consisting of negative pressure vacuum therapy and allogenic skin spray application was instigated. Negative pressure allowed for contraction of the wound edges for granulation, and reduced dehiscence risk. It also increased vascularisation of the exposed bone region inferiorly and significant reduction in wound size. Fresh allogenic human keratinocyte suspension allowed for complete healing of the defect. This involved epithelisation of the superficial layer of the wound, with no remaining exudate and complete bone coverage.This successful result is exemplary of a non-surgical therapy for extensive wounds in aesthetically challenging areas.