Survival of microvascular free flaps in mandibular reconstruction: A systematic review and meta‐analysis

Markiewicz, Michael R.; Bell, R. Bryan; Bui, Tuan; Dierks, Eric J.; Ruiz, Ramon L.; Gelesko, Savannah; Pirgousis, Phillip; Fernandes, Rui

doi:10.1002/micr.22471

Cited by 38 publications

(31 citation statements)

References 69 publications

(139 reference statements)

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“…14 However, the potential risks for adverse reactions and clinical complications have yet to be discussed. 1,4 Most patients with head and neck cancer, who are potential recipients of microvascular reconstruc-tion, show a positive medical history for nicotine abuse with subsequent arteriosclerosis and a prolonged AT. 15 Wood et al investigated the viability of the AT in 84 forearms to detect anatomical alterations with regard to the palmar blood supply.…”

Section: Discussionmentioning

confidence: 99%

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Hand Perfusion in Patients with Physiological or Pathological Allen's Tests

Bartella

Flick

Kamal

et al. 2018

J reconstr Microsurg

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Section: Discussionmentioning

confidence: 99%

“…This leaves the surgeon two options: (1) to choose a different flap and compromise on the flap design and pedicle length, while accepting that the patient's atherosclerosis is likely to influence any other flap, or (2) manage with a pathological AT and check the perfusion of the hand intraoperatively while raising the RFFF.…”

mentioning

confidence: 99%

Hand Perfusion in Patients with Physiological or Pathological Allen's Tests

Bartella

Flick

Kamal

et al. 2018

J reconstr Microsurg

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“…However, these sites tend to play a niche role in head and neck reconstruction. Some units have focussed on one donor site over another although there is no evidence that one flap is more reliable than another and ideally, patient preferences can be matched with the defect requirements by a surgeon who has a diverse range of reconstructive options at their disposal.…”

Section: Contemporary Practicementioning

confidence: 99%

Reconstruction of major defects of the jaws

Batstone

2018

Australian Dental Journal

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Prosthetic replacements in the 19th and early 20th century were superseded by pedicled flaps and obturators. These have subsequently been superseded by free tissue transfer which currently is the mainstay of reconstructive jaw surgery. Although malignant and benign processes of the jaws are the predominant cause of segmental defects, a significant proportion still occurs due to trauma, or even iatrogenic causes such as radiotherapy. The varied aetiologies demand a nuanced approach to reconstruction and although the techniques remain similar the timing can be quite different. The maxilla and the mandible are both amenable to composite reconstruction with bone. The fibula, iliac crest, scapula, distal radius and medial femoral condyle are the most commonly utilised donor sites for vascularised reconstruction. Each has strengths and weaknesses and the requirements of the defect, and patient preference should outweigh surgeon preference. Osseointegrated implants allow reliable rehabilitation of the dentition by anchoring facial prostheses. Their integration into composite flaps is highly reliable although soft tissue management can be challenging. Virtual surgical planning and 3D printing have already impacted on the surgical workflow and improved the reliability and accuracy of results. If this technology can be applied to tissue typing and human tissue (instead of just plastic and metal) a fully prefabricated and vascularised jaw without donor site morbidity would be the ultimate aim.

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“…Dentro de las imágenes e instrumentos preoperatorios y perioperatorios uno de los fundamentales en la sobrevida del colgajo es la ecografía Doppler, la cual nos presenta la vitalidad de nuestro colgajo a través del flujo de los vasos anastomizados, así como también la evaluación de la vascularización del sitio donante, otro método utilizado es la angiografía convencional, pero el costo beneficio de esta técnica y el avance de la tecnología doppler han desplazado este método (Furnas & Rosen, 1991;Markiewicz et al;Chae et al, 2015). La intervención precoz de los colgajos que presentan fallas o falta de irrigación es fundamental, por lo tanto los métodos e instrumentos para detectar y diagnosticar estas fallas son esenciales, a raíz de eso se han utilizado y propuesto distintos métodos tales como: láser Doppler transcutáneo, fluoresencia intravenosa espectroscopía óptica, monitor de PO 2 tránscutáneo.…”

Section: Huentequeo-unclassified

“…La necesidad de contar con tejido óseo de medianas y grandes extensiones tuvo su respuesta en este colgajo. Indicados en defectos de más de 7 cm (Bayne et al, 2014), con buenos resultados en diferentes estudios sobre todo en la reconstrucción mandibular (Markiewicz et al, 2015;Brown et al, 2017). Su principal contraindicación radica en la falla de la irrigación de la extremidad.…”

Section: Introductionunclassified

Colgajos Microvascularizados en Reconstrucción Maxilofacial: Avances de la Microcirugía

Huentequeo-Molina

Pino-Diaz

Moreno-Apablaza

et al. 2018

Int. J. Odontostomat.

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RESUMEN: La reconstrucción de la cabeza y el cuello contempla avances importantes a lo largo de los años. Los colgajos microvasculares se han convertido en la primera opción de tratamiento en grandes defectos del territorio maxilofacial, mientras tanto, la tecnología con el uso de microscopía y luego las imágenes como CT, angiografía por tomografía computarizada, dispositivo ultrasónico, RNM o Doppler contribuyen a lograr una predictibilidad excepcional de estos colgajos microvasculares. Por lo general, la técnica de anastomosis consiste en una sutura de 9-0 en 360°, pero existen autores que han descrito diversos métodos que no son de sutura con un rendimiento aceptable. Existe un buen número de diferentes colgajos microvasculares, cuatro de ellos son los más comunes en la reconstrucción maxilofacial: fíbula, ilíaco, antebrazo radial, escápula. Además el colgajo anterolateral, muy útil en defectos de piel y tejidos blandos. La evolución de los colgajos microvasculares implica los colgajos quiméricos, muy útiles en defectos grandes. El objetivo de este artículo es describir y exponer el desarrollo de la microcirugía y las diversas opciones de colgajos microvasculares en la reconstrucción maxilofacial.

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Survival of microvascular free flaps in mandibular reconstruction: A systematic review and meta‐analysis

Cited by 38 publications

References 69 publications

Hand Perfusion in Patients with Physiological or Pathological Allen's Tests

Hand Perfusion in Patients with Physiological or Pathological Allen's Tests

Reconstruction of major defects of the jaws

Colgajos Microvascularizados en Reconstrucción Maxilofacial: Avances de la Microcirugía

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