Reconstructive Outcomes After Extensive Facial Infections: A Narrative Review

• DOI: https://doi.org/10.22533/at.ed.1595322522101

• Palavras-chave: Reconstrução facial; Fasciíte necrosante; Mucormicose; Resultados cirúrgicos; Cirurgia reconstrutiva.

• Keywords: Facial reconstruction; Necrotizing fasciitis; Mucormycosis; Surgical outcomes; Reconstructive surgery.

• Abstract: Abstract Background: Extensive facial infections represent one of the most devastating and complex clinical challenges, bridging the domains of infectious disease, reconstructive surgery, and critical care. These infections—whether bacterial, polymicrobial, or fungal—can rapidly cause composite tissue loss, severe functional impairment, and profound psychosocial distress. Advances in antimicrobial therapy and critical support have improved survival, but the focus of care has shifted toward reconstruction and long-term rehabilitation. Objective: This narrative review aims to synthesize current evidence regarding reconstructive outcomes after extensive facial infections, emphasizing timing of intervention, surgical strategies, functional and aesthetic results, and the multidisciplinary factors that influence prognosis. Methods: A comprehensive literature search was conducted using PubMed, Scopus, and Embase for studies published up to May 2025. Both retrospective and prospective studies, case series, and reviews describing reconstructive techniques or outcomes following infection-related facial tissue loss were included. Results: Findings indicate that early reconstruction—performed once infection control and systemic stabilization are achieved—can improve function, reduce scarring, and shorten hospital stay. Microvascular free tissue transfer remains the gold standard for large, composite defects, while local and regional flaps continue to play critical roles in resource-limited or unstable settings. Functional recovery correlates with early physiotherapy and multidisciplinary follow-up. Aesthetic and psychosocial outcomes depend heavily on symmetry, color match, and timely psychological support. Conclusion: Reconstruction after extensive facial infection transcends technical repair—it is an act of anatomical, functional, and emotional restoration. Optimal outcomes require individualized timing, interdisciplinary collaboration, and continuous refinement of both technique and compassion. Future research should aim to establish standardized outcome measures and explore emerging technologies such as 3D planning and regenerative scaffolds to further enhance recovery and reintegration.