MD E. Zacharevskij1 , MD PhD V. Kaikaris1, MD PhD R. Rimdeika1, G. Samulėnas2 1Department of Plastic and Reconstructive Surgery, Hospital of Lithuanian University of Health Sciences 2Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences

1. Consecutive reconstructive surgery of trunk, neck and face deformities after burn injury
MD E. Zacharevskij1 , MD PhD V. Kaikaris1, MD PhD R. Rimdeika1, G. Samulėnas2
1Department of Plastic and Reconstructive Surgery, Hospital of Lithuanian University of Health Sciences
2Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences
Introduction
A 25 year old man at the age of fifteen was injured in a fire
accident and underwent long hospital stay and several skin
transfer operations. During the post injury period he suffered
from residual skin contractures, located in the left armpit
region, neck, face and microoris.
Reconstructive operations schedule was composed for the
patient considering main complains and major post burn
contractures.
•Firstly, scar excision and skin flap rotation was performed in
the left armpit region in order to increase left hand
elevation.
•Next procedure was a combined microoris correction with
infranasal region plasty and expander insertion.
•After three months of expanding there was sufficient skin to
cover right neck region after eliminating the neck
contracture. In post-operative period patient underwent
physiotherapy and scar reducing procedures.
Discussion
Burn survivors face a variety of chalenges, including
physical, psychological and social aspects. The generic
health status (SF-36 questionare) of a burn patient is
significantly lower than general population scores.1 The
Health Related Quality of Life (HRQoL) scores are worse
in comparison with general population (respectively
0,839 ± 0,125 and 0,936 ± 0,071),and do not improve
significantly during 2-year follow up2. Consecutive
surgical approach could modify physical aspects and
decrease dissatisfaction of body appearance, thus
lowering chances of depression.
We report a case of a successful multi-stage reconstruction of
a burn injury, which included body areas of high importance
concerning psychological and physical aspects.
Case presentation
Results, conclusions
After two years of treatment patient has proper left hand
elevation, neck rotation and microoris correction. Patients after
deep skin burns need permanent supervision and an incentive
to start treatment3. Well planed consecutive reconstructive
surgery significantly improves life quality of burned patients.
References
1.Moi, A.L., Wentzel-Larsen, T., Salemark, L., Wahl, A.K., Hanestad, B.R. Impaired generic
health status but perception of good quality of life in survivors of burn injury. Journal of
Trauma - Injury, Infection and Critical Care, Volume 61, Issue 4, October 2006, Pages 961-
968
2.Koljonen V, Laitila M, Sintonen H, Roine RP. Health-related quality of life of hospitalized
patients with burns-comparison with general population and a 2-year follow-up.
Burns. 2013 May;39(3):451-7
3.Rea SM, Goodwin-Walters A, Wood FM. Surgeons and scars: differences between
patients and surgeons in the perceived requirement for reconstructive surgery following
burn injury. Burns. 2006 May;32(3):276-83
Depression
Physical function
Age
Body image
dissatisfaction
TBSA (%) burned
Facial burn
Female sex
Before operation
Expander insertion and filling stages