i-gel as an airway device in an anticipated difficult airway in a patient with bear bite and flap overgrowth post-surgery

作者：B. Gupta, N. Gupta, H. Jaishankaraswamy, Debariti Chattopadhyay, Kamna Kakkar · 发表于：Korean Journal of Anesthesiology · 年份：2020 · DOI：10.4097/kja.20185 · 研究领域：Medicine

tions involving the eyes, lips, nose, and maxillofacial structures. These facial injuries require multiple reconstructive surgeries to achieve long-term aesthetic and functional outcomes. Case scenario 1: A 45-year-old woman (weight: 53 kg, height: 168 cm) presented to the emergency room with a history of an offensive attack on face by a sloth bear. The patient provided informed written consent for the publication of her case report in the medical literature. At the time of presentation, she had facial disfigurement with a right orbital fracture, loss of the right cheek, split palate, and mandibular fracture (Fig. 1A). A tracheostomy was performed owing to difficult airway at the time of presentation, followed by initial debridement and suturing. Seven days later, a free anterolateral thigh flap reconstruction was performed. The flap failed on the 8 post-surgery day because of sudden extensive hemorrhage. A radial artery forearm extracorporeal flap used as salvage partially covered the defect. Finally, a trapezius myocutaneous flap was used for resurfacing, followed by multiple scalp rotation flaps. All five reconstructive surgeries were performed under general anesthesia via the tracheostomy port. Her tracheostomy site was closed 9 months after the injury. Case scenario 2: The same patient presented for flap revision after undergoing multiple surgeries; we noted overgrowth of the myocutaneous flap over the right cheek and neck (Fig. 1B). Flap revision and cutting were requir...