Prelaminated Forehead Flap Nasal Reconstruction of Pediatric Nasal Defect Secondary to Necrotizing Soft Tissue Infection: A Case Report

Background

Necrotizing soft tissue infection (NSTI) in children that involves the nose is a rare presentation and requires serial surgical debridement followed by nasal reconstruction. Nasal reconstruction is often delayed until post-pubertal age due to ongoing facial growth, limited local tissue/donor sites, and poor adherence to post-surgical care. However, the facial defect has a greater psychosocial impact as the child grows. Case: This case report describes an 8-month-old boy who developed necrotizing fasciitis of the right heminose/cheek following an iatrogenic laceration from a nasal oxygen cannula, which required urgent surgical debridement and antibiotic therapy. We performed a multi-stage reconstruction using a prelaminated forehead flap with a composite concha cartilage and skin graft.