Expert intervention restores the face
of a young girl

A 17-year-old patient with facial trauma was transferred to Nanavati Super Speciality Hospital from a peripheral hospital. Initial assessment of the patient in the Emergency Department reported that the patient was stable. CT scan revealed facial bone fractures, however, no head injury or respiratory distress was detected. There was also no bodily injury. At the time of admission, she had a dressing on the left side of her face and a slab on the right forearm. The patient was admitted to the CCU and was immediately started on antibiotics and analgesics. A full investigation of profile was scheduled. The patient also suffered from edema, and the left side of the face had drooped down with a large gamgee wrapped across the head like a turban.

The initial look of the patient showed a degloved left side face completely black and containing gravels. A lot of tissues were also missing in the cheek and temple region. An immediate bedside wash was given, and the patient was posted for debridement and closure. The patient was given tetglob and aggs cover. Debridement and immediate reconstruction were the most challenging decision; however, early management proved to be a preferable choice. It took more than an hour to remove each and every speck of gravel from

“When the patient was brought to the hospital, she had suffered a major facial trauma and the left side of her face had drooped down. No bodily injury was recorded." 1

the nook and cranny of orbit pterygoid fossa skin subcut lower lid and upper lip.

The face back was suspended to the zygomatic arch and temporalis fascia to close a large tissue defect partially. The patient also had a right forearm circumferential degloving injury. After a few days, the temple and forearm were grafted along with facial bone fracture plating to restore shape and occlusion. Together with Dr. Anshuman Manasvi – Consultant, Plastic Surgeon, the team was ultimately able to provide her with a decent reconstruction.

The patient was discharged following a progressive recovery but will require further interventions in the future to remove the small area of graft in the left temple region.

Dr. Pradeep B. Bhosale

Dr. Parag Vibhakar
Sr. Consultant
Plastic, Reconstructive,
Microvascular and
Cosmetic Surgeon
Nanavati Super
Speciality Hospital