Reconstruction of nasal defects using modified composite grafts

Chandawarkar, Rajiv Y.; Cerviño, Alejandro; Wells, Mark D.

doi:10.1016/s0007-1226(03)00004-3

Cited by 36 publications

(20 citation statements)

References 21 publications

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“…Besides graft size, other factors have been described having an important influence on graft take: degree of contact between graft and recipient bed, quality of recipient site, and metabolic factors. 9 In 1956, Conley and Vonfraenkel reported on the principle of cooling composite nasal grafts to reduce graft metabolism to improve their take. 12 However, duration, quality, and quantity of cooling are practical factors, which still remain under-standardized until today.…”

Section: Discussionmentioning

confidence: 99%

“…Alternative technical applications of the classical ''end-to-end'' type of union include a ''tongue-in-groove'' principle that was illustrated by Davenport and Bernard in 1959, 10 interlocking of cartilaginous pegs, 11 or the preparation of extended dermal pedicles that have at least twice the size of the transplant, as discussed by Chandawarkar et al in 2003. 9 A disadvantage of these methods is that a complex preparation of the recipient site is necessary with a wide dissection of the transplant pocket along the nasal dorsum, 9 limiting the size of the transplant to 2 cm, and increasing the risk for infection or scarring, which could compromise the final functional or cosmetic result.…”

Section: Discussionmentioning

confidence: 99%

“…Many technical modifications of the classical ''end-to-end'' graft inset are aimed at providing a broader contact surface between graft and recipient site. [9][10][11] In addition, postoperative cooling of the graft surface 12 and hyperbaric oxygenation 13 have been shown to improve graft take. The fact that many different technically sophisticated procedures are in use indicates that the one ideal method for grafts wider than 1.5 cm has not been found yet.…”

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confidence: 99%

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One-Stage Reconstruction of Nasal Defects: Evaluation of the Use of Modified Auricular Composite Grafts

Teltzrow

Arens²,

Schwipper

2011

Facial plast Surg

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Complex nasal defects in the distal regions of the nose are cosmetically difficult to repair. In 70 patients over a period of 10 years, defects of the nasal ala and the soft triangle, nasal tip, columella, and columellar-lobular junction were reconstructed with modified auricular composite grafts. A randomized group of 40 of these patients was assessed after a mean of 55.5 months to evaluate the method's functional and cosmetic long-term results. The majority of the patients (60%, N = 48) had been treated primarily for basal cell carcinoma. Of all defects, 57% ( N = 46) measured 2 to 3 cm in width and 43% ( N = 34) 1 to 2 cm. Seventy-five percent ( N = 60) of all defects were composite lesions involving skin, cartilage, and vestibular mucosa, in contrast to 25% ( N = 20) involving skin and cartilage with intact vestibular skin. Two crucial technical modifications seemed to have improved survival for larger grafts: first, the use of hinge flaps from the margins of the defect to obtain a well-vascularized recipient bed and optimization of the raw contact surface; second, postoperative gentle scarification of the graft in combination with a constantly applied heparin solution decongests venous stasis normally seen in such grafts. This maneuver establishes a stable and early blood supply enhancing graft take. With this type of treatment, 67 (84%) grafts healed well without further complications, whereas 13 (16%) grafts developed complications, resulting in partial ( N = 9) and total ( N = 4) necrosis of the transplant. Six of these patients underwent a secondary reconstruction using another auricular composite graft. Long-term results of this method have turned out to be very satisfying in terms of functional and cosmetic outcome and patient acceptance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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One-Stage Reconstruction of Nasal Defects: Evaluation of the Use of Modified Auricular Composite Grafts

Teltzrow

Arens²,

Schwipper

2011

Facial plast Surg

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“…Furthermore, the defect in this case is known to be very unfavorable for the survival of composite grafts. Chandawarkar et al [29] in their experience with auricular composite grafting stated that at the columellar-lobular junction, alar rim and the soft triangle, partial composite graft loss is a rule rather than the exception.…”

Section: Discussionmentioning

confidence: 99%

Supermicrosurgical replantation of a small amputated nasal tissue in a child

Tee

Woodfield

2017

Clinical Case Reports

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Key Clinical MessageThis study reports a case of an 8‐year‐old boy who suffered from a dog bite injury to the nose. The amputated nasal tissue measured approximately 1.0 × 1.5 cm and included part of the tip, alar, and soft triangle subunits. Both ends of an artery of less than 0.5 mm were found, and replantation was performed. Chemical leeching was performed postoperatively. At 5‐year follow‐up, a good aesthetic result was achieved.

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“…The forehead should be spoiled as little as possible in partial and total reconstruction of the nose. Nasal defects in certain areas such as the columellarlobular junction, the alar rim, and the soft triangle are cosmetically challenging to reconstruct (4).…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of nasal defect with the composite expanded forehead flap

Vikšraitis¹,

Maslauskas²,

Bagdonas

2010

Medicina

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Nasal tip and septal perforations may lead to significant upper airway problems as well as disturbing esthetic changes in the external contour of the nose. Nasal defects impede normal social contact and create great self-identity problems for the patients. We report the case of a 37-year-old woman, taking drugs for 10 years, who had sepsis and nasal abscess with necrosis of the nasal tip and septum. Using a composite expanded forehead flap for reconstruction of the nose, good esthetic and functional results were achieved.

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Reconstruction of nasal defects using modified composite grafts

Cited by 36 publications

References 21 publications

One-Stage Reconstruction of Nasal Defects: Evaluation of the Use of Modified Auricular Composite Grafts

One-Stage Reconstruction of Nasal Defects: Evaluation of the Use of Modified Auricular Composite Grafts

Supermicrosurgical replantation of a small amputated nasal tissue in a child

Reconstruction of nasal defect with the composite expanded forehead flap

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