Reconstruction of a Patient with Severe Craniofacial Burns in a Conflict Zone in Burkina Faso: The Story of the Sole Survivor of a Plane Crash

Introduction: Severe burns to the face pose functional and aesthetic problems. Treatment may be delayed or inadequate when cases occur in unsafe areas. We report a clinical case of a severe burn following a helicopter crash. Clinical Case: The patient was a 41-year-old man, the sole survivor of a helicopter crash in a region with a precarious security situation. This patient, with no medical history, presented with multiple 2nd and 3rd degree craniofacial burns and burns to the pelvic and thoracic limbs, with an estimated total body surface area burn of 18%. He was initially treated in a general surgery department, where he underwent several dressings and bandaging procedures, and was then referred to maxillofacial surgery one month after his burns. The examination revealed granulation wounds on the left side of the face, loss of upper eyelid tissue, ectropion and early-stage exposure keratitis. A multidisciplinary approach was adopted, involving ophthalmologists to prevent corneal complications. The surgical treatment was carried out in several stages: full-thickness skin grafting in the facial aesthetic unit, thin skin grafting in the fronto-temporal region, Cutler-Beard flap and glabellar flap for eyelid repair. The outcome was favourable, with good graft integration, eye protection and a noticeable aesthetic improvement. Further procedures are planned to optimise the result. Conclusion: This case illustrates the possibility of effective reconstruction of a severe facial burn despite an initial delay, thanks to a multidisciplinary approach and appropriate, innovative surgical techniques.