Accidental injury to the face can range from superficial wounds requiring dressings to full thickness wounds that require the skills of a plastic surgeon.
The cause of these injuries could be from animal bites, from fights, accidental falls and motor vehicle accidents.
Contaminated wounds would require debridement, and removal of foreign bodies such as gravel. Dr Tew will carefully tidy up rougher laceration injuries and use plastic surgery techniques to minimise scarring in the healing phase.
Following such a repair would be months of scar management, as traumatic wounds are prone to inflammation and therefore hypertrophic scars.
Traumatic wounds can sometimes be associated with tissue loss.
For instance, dog bites can result in defects of the lower lip, that require flap reconstruction.
Treatment is dependent on particular injuries and their location. If the skin flap has a proximal base, there is a higher chance of the flap surviving, if sutured without tension, the area is immobilised and elevated for a few days to minimise swelling and tension on the flap.
If the flap has little chance of survival, Plastic surgeons use the Mesh protocol. The Mesh protocol is one way of using the skin flap by separating the flap from its base, thinning the flap, using a mesher to expand the skin and thereby increasing the chance of being taken by effected areas.
Areas unsuitable for the Mesh protocol, would potentially eligible for a split skin graft. The skin would be harvested from other areas of the body, using a Dermatome. The harvested skin is meshed before it is applied to the recipient site. After the skin is applied, a non-adherent dressing followed by foam is applied, and then a negative pressure device. Elevation of the area will reduce swelling and improve the chance of graft take.