Manejo clínico pré-operatório de pacientes candidatos ao transplante facial: relato de caso

Abstract

Introduction: Face transplantation has gained recognition, changing the clinicalsurgical outlook for the restoration of complex facial defects, since it attributes functional and aesthetic recovery to patients who have suffered serious accidents. To date, in official publications, about 43 patients have undergone facial transplantation worldwide. The face transplant has numerous evidences that can provide improvements to the patient in an irrefutable way. For this, preoperative care for the patient must be carefully established, as in this stage the short and long term acquired comorbidities, lifestyle, food, among others, which are essential for the performance of a good surgery, are revealed. Objective: To report the routine of preoperative care and preparation of a patient who is a candidate for facial transplantation attended at a referral unit for reconstructive surgery in Mexico City. Methodology: This was a retrospective and cross-sectional study, which was carried out through the analysis of the medical record of the patient seen between January 2017 and January 2020, in the Ayuda para la Mano Artrítica AC Group, "Tlalpan Team". Report: a 46-year-old male patient reports that, at the age of 6, he had a burn from exposure to gasoline with 72% (TBSA), with sequelae from burns and surgical reconstructions on the face, scar from rotation of the frontal flap, amorphous frontal flap in a nasal site, redundant and ptotic skin flap on the left cheek, absence of upper and lower lip, ectropion on both lower eyelids, bilateral hyperemic conjunctiva, exposure of the lower teeth and loss of definition of the mandibular line. Conclusion: the importance of disseminating this innovative procedure in different medical specialties and preoperative care is emphasized through a thorough investigation, which attributes a better surgical efficacy and a good performance of the patient after the transplant and, thus, enabling the rescue of their facial identity once stigmatized.