Long-Term Follow-Up of Flap Prefabrication in Facial Reconstruction

Wang, Weixin; Zhao, Muxin; Tang, Yong; Chen, Wen; Yang, Zhe; Ma, Ning; Xu, Lizhen; Feng, Jun; Li, Yangqun

doi:10.1097/sap.0000000000000992

Cited by 7 publications

(7 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1,2 There are very few reported cases of TSS, primarily caused by goiter, and cerebral angiogram showed an enlarged thyroid artery blood supply, which was possibly due to the development of goiter, leading to more blood flow to the thyroid and a decrease in intracranial blood flow. 2,3 In 2022, Harrison Humphries and colleagues reported the first case of TSS caused by active hyperthyroidism in a patient who did not have high levels of TSH or goiter, but had high levels of thyroid receptor antibodies that mimic the effects of TSH. 2,5 Our patient had a high TSH level, a large goiter, and obvious enlargement of the thyroid artery.…”

Section: Discussionmentioning

confidence: 99%

“…Since the first mention of flap prefabrication in 1981,13 basic research on its survival mechanism and strategies to improve its survival area has advanced rapidly. To date, prefabricated flaps with arteriovenous bundles have been well-established and widely used to reconstruct head and neck morbidities, such as superficial temporal arteriovenous bundles to prefabricate cervical flaps 3,14. However, owing to the large area and insufficient neovascularization, the blood supply of prefabricated flaps is not stable, which frequently leads to distant ischemic necrosis and ultimately affects their clinical application.…”

Section: Discussionmentioning

confidence: 99%

“…On the demerits, donor pedicles for flap prefabrication, commonly superficial natural arteriovenous bundles,3 are limited in number and fixed in place. Moreover, the main obstacle to its routine clinical application is the limited survival area 4,5.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Prefabrication—a Vascularized Skin Flap Using an Arteriovenous LoopPrefabricated Flap With Arteriovenous Loop

Wang

et al. 2023

Journal of Craniofacial Surgery

Self Cite

View full text Add to dashboard Cite

Background: Arteriovenous loops have a high potency to induce angiogenesis and are promising to solve the problem of scarce implanted pedicle sources and insufficient neovascularization in flap prefabrication. But there is a lack of large animal experiments to support their clinical application. Therefore, we aimed to explore the feasibility of prefabricating large flaps based on arteriovenous loops in pigs. Methods: Five minipigs were used. In the experimental group, a 10-cm-long ear vein graft was microanastomosed with the saphenous artery and vein to form an arteriovenous loop and implanted under the medial thigh flap. A month later, a 10×10 cm prefabricated flap pedicled with the arteriovenous loop was elevated and sutured in situ. In the control group, a 10×10 cm flap with no vascular pedicle was elevated completely and sutured in situ in the same position. The patency of the arteriovenous loop was evaluated by angiography 30 days after implantation, and the viability of flaps was assessed by macroscopic analysis 10 days after elevation. Three animals received arteriovenous loop flaps unilaterally and no-pedicle flaps unilaterally. Two animals received arteriovenous loop flaps bilaterally. Results: In the experimental group, no thrombi were exhibited in any arteriovenous loop. All 7 prefabricated flaps survived uneventfully. In the control group, 3 flaps were completely necrotic. Conclusion: The arteriovenous loops with long interpositional venous grafts can be used as vascular pedicles to prefabricated large area and well-vascularized flaps. This approach can greatly expand the application of flap prefabrication.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prefabrication—a Vascularized Skin Flap Using an Arteriovenous LoopPrefabricated Flap With Arteriovenous Loop

Wang

et al. 2023

Journal of Craniofacial Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…Flap prefabrication is a clinically applied method to generate custom made transplants with the help of arterializing tissue either with arteriovenous bundles or arteriovenous loops [35] . It has been described for various tissues, including skin, fasciae, muscle, periosteum and/or bone [36][37][38][39] . In the clinical scenario both arterial and venous supercharging have been postulated to potentially improve the survival area of prefabricated flaps and to extend the possibilities of creating custom made tissue flaps [40][41][42] .…”

Section: Importance Of the Av Loop Model For Reconstructive Medicinementioning

confidence: 99%

Prefabricated flaps and neoangiogenesis initiated via venous grafts in arteriovenous loops

Polykandriotis¹,

Arkudas²,

Weigand³

et al. 2018

PAR

View full text Add to dashboard Cite

New developments in regenerative medicine are bound to revolutionize the way we approach loss of function and form in human organisms. Especially in the field of reconstructive plastic surgery new biotechnologies find their way from bench to bed. Biofabrication is an evolving field that aims to combine natural biologic processes with bioartificial constructs with the scope of reconstituting tissue without having to rely on autotransplantation. In this brief review we present the concepts of intrinsic vs. extrinsic neovascularization and we discuss the use of neovascularization in three dimensional matrices. In a clinical context matrix flaps for application in reconstructive surgery can be fabricated this way.

show abstract

“…For bone defects, grafts have to be adjusted by osteotomy to resemble the natural contouring which can be associated with the risk of devascularization since periosteal blood supply is often not macroscopically obvious [6]. With prefabrication techniques, it became possible to turn a random vascularized flap of desired shape, thickness, and texture into an axially vascularized flap [8]. Using this type of flap manipulation, autologous tissues, such as bone grafts, are implanted for several weeks into a highly vascularized area of the body, such as a fasciocutaneous pocket [9].…”

Section: The Technical Challenge: Reconstruction Of Large-scale Tissumentioning

confidence: 99%

The Arteriovenous Loop: Engineering of Axially Vascularized Tissue

et al. 2018

View full text Add to dashboard Cite

Background: Most of the current treatment options for large-scale tissue defects represent a serious burden for the patients, are often not satisfying, and can be associated with significant side effects. Although major achievements have already been made in the field of tissue engineering, the clinical translation in case of extensive tissue defects is only in its early stages. The main challenge and reason for the failure of most tissue engineering approaches is the missing vascularization within large-scale transplants. Summary: The arteriovenous (AV) loop model is an in vivo tissue engineering strategy for generating axially vascularized tissues using the own body as a bioreactor. A superficial artery and vein are anastomosed to create an AV loop. This AV loop is placed into an implantation chamber for prevascularization of the chamber inside, e.g., a scaffold, cells, and growth factors. Subsequently, the generated tissue can be transplanted with its vascular axis into the defect site and anastomosed to the local vasculature. Since the blood supply of the growing tissue is based on the AV loop, it will be immediately perfused with blood in the recipient site leading to optimal healing conditions even in the case of poorly vascularized defects. Using this tissue engineering approach, a multitude of different axially vascularized tissues could be generated, such as bone, skeletal or heart muscle, or lymphatic tissues. Upscaling from the small animal AV loop model into a preclinical large animal model could pave the way for the first successful attempt in clinical application. Key Messages: The AV loop model is a powerful tool for the generation of different axially vascularized replacement tissues. Due to minimal donor site morbidity and the possibility to generate patient-specific tissues variable in type and size, this in vivo tissue engineering approach can be considered as a promising alternative therapy to current treatment options of large-scale defects.

show abstract

Long-Term Follow-Up of Flap Prefabrication in Facial Reconstruction

Abstract: Because flap prefabrication is practical, and long-term follow-ups have proved its preferable characters and stability, it is a fine method for large area facial reconstructions.

Cited by 7 publications

References 21 publications

Prefabrication—a Vascularized Skin Flap Using an Arteriovenous LoopPrefabricated Flap With Arteriovenous Loop

Prefabrication—a Vascularized Skin Flap Using an Arteriovenous LoopPrefabricated Flap With Arteriovenous Loop

Prefabricated flaps and neoangiogenesis initiated via venous grafts in arteriovenous loops

The Arteriovenous Loop: Engineering of Axially Vascularized Tissue

Contact Info

Product

Resources

About