Reconstructive operations for leprous disfigurement of the face

ABSTRACT

The communication is based on the experience with 380 reconstructive operations in the face fo patients at the residual stage of leprosy. A classification of the sequelae of leprosy in the face, which includes all types of disfigurement and facilitates selection of the most rational method of surgical treatment for each group, has been elaborated. in most patients who have overcome leprosy, a combination of all kinds of deformations and defects in the facecan be observed, which requires a whole complex of plastic operations in order to take off the mask of leprosy. Reconstructive operations in the face are indicated at the stage of deep regression or in residual leprosy. The paper deals with the successful repair of deformations of the nose by means of dividing the subcutaneous scar contractures and of constructing a supporting cartilage scaffolding, of reconstructing the nose and lips with a Filatov pedicle flap, of repairing facila-muscle palsy with a tape of fascia and lagophthalmos with a myofascial-band plasty, of reconstructing the eye browns with arterialized flaps on subcutaneous pedicles, and of other reconstructive and cosmetic operations. The skin wounds have healed well in leprosy patients, and no hypertrophic or kelloid scar formation has been observed.