Prefabricated and Prelaminated Flaps for Head and Neck Reconstruction

Pribaz, Julian J.; Fine, Neil A.

doi:10.1016/s0094-1298(20)32362-2

Cited by 83 publications

(24 citation statements)

References 20 publications

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“…The epidermis of the radial forearm flap is thin, and the color of flaps from the upper extremity often adapts over time. Prefabricated flaps using, for example, supraclavicular skin at the neck area have the advantage of replacing tissue with (almost) like tissue 59 and are therefore a good option for forehead reconstruction. However, this approach is not an alternative when immediate reconstruction is needed after trauma or in cases of malignancy.…”

Section: Treatment Recommendations For Defects At the Foreheadmentioning

confidence: 99%

Scalp and Forehead Reconstruction

Lutz¹

2010

Seminars in Plastic Surgery

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The treatment of scalp and forehead defects is challenging. There are few cases in which an untreated scalp defect can heal by secondary intention. However, lack of adequate treatment can also lead to fatal consequences. Adequate judgment and treatment of a defect on the scalp are therefore mandatory. There are many options to reconstruct a scalp defect. Each option has its role in the reconstruction repertoire. Various factors need to be considered when choosing the method to be used. These factors include etiology and the size of the defect, age and general health of the patient, as well as the situation at the hospital/unit where the treatment is performed. In this article, different reconstruction methods are presented, and guidelines for the selection of the various options are provided.

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Section: Treatment Recommendations For Defects At the Foreheadmentioning

confidence: 99%

Scalp and Forehead Reconstruction

Lutz¹

2010

Seminars in Plastic Surgery

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“…In humans, this process may be slower, and in the authors' clinical experience 8 weeks or even longer provides a relatively safe margin. 1 However, maturation can be hastened by several maneuvers. Angiogenic factors, such as basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF), have been shown in animal models not only to improve flap survival but also to increase flap durability in the presence of infection.…”

Section: Flap Prefabricationmentioning

confidence: 99%

“…With the advent of microsurgery and a better understanding of the axial blood supply of flaps, the reconstructive options have expanded greatly over the past 20 years. 1 However, many unique challenges remain in the head and neck. Local options are usually limited to the repair of relatively small defects.…”

mentioning

confidence: 99%

Flap Prefabrication and Prelamination in Head and Neck Reconstruction

2003

Seminars in Plastic Surgery

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Flap prefabrication and prelamination are relatively new concepts in reconstructive surgery. Although closely related, they are two uniquely different techniques. They are primarily employed in reconstructing complex defects that cannot be repaired with simpler and more conventional techniques. For the head and neck, where defects are often complex, donor options few, and aesthetic demands high, the role of prefabricated and prelaminated flaps is becoming increasingly important. Flap prefabrication starts with transposition of a vascular pedicle into a body of donor tissue that otherwise does not possess an axial blood supply. Flap prelamination, on the other hand, starts with addition of tissue layers into an established vascular bed. Both procedures then require a second stage in which a prefabricated or prelaminated flap is transferred to its final location. This article describes our experience with flap prefabrication and prelamination in the head and neck, reviews the literature, and speculates on the future potential of these reconstructive techniques, especially with evolving tissue engineering and embryonic stem cell technologies.

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“…Flap prelamination, however, is a different concept as Guo and Pribaz 5 have clarified in their excellent paper: flap prelamination describes a technique in which additional tissue is added to an existing flap (without manipulation of its axial blood supply) to make a multilayered flap that may be used for complex, three-dimensional defect reconstructions. 6 There are few reports in the literature on the use of vascularized fascia as carrier for prelaminated flaps. 7,8 In this experimental study, we used vascularized fascia to create prelaminated chondrofascial and osseofascial flaps.…”

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confidence: 99%

The Use of Vascularized Fascia as Carrier in Cases of Prelaminated Fasciocartilaginous and Osseofascial Flaps

Tsagarakis¹,

Spyropoulou

Lykoudis

et al. 2016

J reconstr Microsurg

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Background This experimental study investigates the use of vascularized fascia as carrier for prelaminated cartilage and bone flaps. Methods A total of 30 male New Zealand white rabbits were divided into two equal groups (A and B). The fascia surrounding the inguinal fat and superficial inferior epigastric vessels was dissected. In group A, the fascia was wrapped around a template (20 × 40 mm) of cartilage harvested from the rabbit's ear. In group B, the fascia was wrapped around a 15 × 35 mm piece of rib cortical bone. After a maturation period of 4 weeks, group A was subdivided into three groups (A1, A2, and A3). In group A1 (six animals) the animals were sacrificed and the flaps were sent for histological examination, in A2 (six animals) the flaps were rotated 180 degrees and anchored at knee level, and in A3 (two animals) the flaps were transferred as free flaps to the right SIE (superficial inferior epigastric vessels). The animals of subgroups A2 and A3 were sacrificed after another maturation period of 2 weeks and the flaps were sent for histological examination. After a maturation period of 6 weeks, group B was subdivided into three subgroups (B1, B2, and B3) corresponding to the cartilage subgroups. Subgroups B2 and B3 were sacrificed after 2 weeks. Results All flaps of groups A and B demonstrated good viability apart from one specimen of subgroup B2. Angiogenesis was present in all groups. Conclusion Meticulously dissected vascularized fascia can be successfully used for prelamination of complex fasciocartilaginous or osseofascial flaps. The required maturation periods are 4 and 6 weeks, respectively.

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Prefabricated and Prelaminated Flaps for Head and Neck Reconstruction

Cited by 83 publications

References 20 publications

Scalp and Forehead Reconstruction

Scalp and Forehead Reconstruction

Flap Prefabrication and Prelamination in Head and Neck Reconstruction

The Use of Vascularized Fascia as Carrier in Cases of Prelaminated Fasciocartilaginous and Osseofascial Flaps

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