The Effects of Early Postoperative Radiation on Vascularized Bone Grafts

Evans, H Brian; Brown, Sylvia T.; Hurst, Lawrence N.

doi:10.1097/00000637-199106000-00002

Cited by 39 publications

(20 citation statements)

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“…Previous studies on irradiated bone have shown an impairment of vascular tissues [3] with a decrease in production of vascular growth factors. Radiation in bone tissue causes a decrease in proliferation of bone-forming cells, leading to their accelerated differentiation [18].…”

Section: Discussionmentioning

confidence: 89%

“…As regards the abovementioned data, irradiation therefore seemed to be the main factor that limited bone formation with the BCP-MSCs mixtures used in our study. The lack of vascularization and vascular growth factors commonly observed in irradiated bone [3] could be the major explanatory factor for these results. In a deprived bone marrow without appropriate blood perfusion, the osteogenic growth factors [29] and the cells producing them are probably lacking or unable to promote the osteogenic differentiation of MSCs in vivo.…”

Section: Discussionmentioning

confidence: 94%

“…Furthermore, irradiation produces irreversible sideeffects on tissues and increases the risk of vascularized flap failure [2]. The side-effects of radiation on bone are characterized by reduced healing capacities because of the decreased amount of cells and vessels [3].…”

Section: Introductionmentioning

confidence: 99%

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A comparison between bone reconstruction following the use of mesenchymal stem cells and total bone marrow in association with calcium phosphate scaffold in irradiated bone

et al. 2009

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 94%

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A comparison between bone reconstruction following the use of mesenchymal stem cells and total bone marrow in association with calcium phosphate scaffold in irradiated bone

et al. 2009

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“…Vascularization of this system plays an important role, considering that the comparison of vascularized and non-vascularized grafts in an animal model revealed that integration to the adjacent bone was faster in the vascularized grafts, although all of them achieved adequate bone formation in the 20 and 30-week follow-ups (Evans et al, 1991).…”

Section: Discussionmentioning

confidence: 99%

Variation in the Repair of a Rib Graft used for Mandibular Reconstruction after 20 years

Pozzer¹,

Olate²,

Moraes³

et al. 2015

Int. J. Morphol.

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“…This technique is particularly well suited for defects of the anterior mandibular arch [11]. It is known that (a) this type of surgical intervention allows better conditions for healing than non-revascularised grafts and (b) the soft tissue part of the transplant is essential for adequate healing of bone [12,13]. The criteria for adequate healing of microvascular anastomosed pedicled flaps are different from those for the non-vascularised grafts, and the time of evaluation has shifted to a much earlier period after the reconstructive procedure.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and prognostic value of 99mTc-tetrofosmin scintigraphy in maxillofacial flaps

Aigner

Schultes

Sorantin

2003

Eur J Nucl Med Mol Imaging

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In oro-maxillofacial malignancies, new therapeutic approaches are placing changing demands on the diverse diagnostic modalities. In contradistinction to mandibular reconstruction of former years, the transplants (microvascular anastomosed pedicled flaps, "flaps") now consist of one or more arteries feeding a soft tissue component attached to a piece of bone suitably fitted to fill the defect. We addressed the diagnostic value of technetium-99m tetrofosmin scintigraphy in differentiating between viability and non-viability of the soft tissue portion of flaps in the immediate postoperative assessment. A total of 60 patients who had received flaps for reconstruction of the mandible after partial resection were investigated with (99m)Tc-tetrofosmin 3-5 days after surgery. Scintigraphy consisted of (a) radionuclide angiography, (b) static planar imaging in four projections starting at 10 min post injection, and (c) single-photon emission tomography (SPET) performed immediately after the planar imaging. Normal perfusion associated with no defects throughout the soft tissue portion of the transplant was observed in 46/60 patients. This scintigraphic pattern was identical to viability and normal postoperative follow-up. Hypoperfusion and small defects on planar and SPET images indicated viability and uncomplicated postoperative healing in 6/60 patients, but non-viability/inadequate healing of the flap in 4/60 patients. Absence of perfusion combined with a large defect on static planar and SPET images definitively showed the non-viability of the flap (4/60 patients). It is concluded that (99m)Tc-tetrofosmin scintigraphy is a sensitive diagnostic tool for the immediate postoperative assessment of the viability and the adequacy of implantation of the soft tissue portion of flaps. Therefore tetrofosmin scintigraphy is an important modality in order (a) to define the optimal therapeutic regimen in the immediate postoperative period and (b) to provide better prognosis.

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The Effects of Early Postoperative Radiation on Vascularized Bone Grafts

Cited by 39 publications

References 0 publications

A comparison between bone reconstruction following the use of mesenchymal stem cells and total bone marrow in association with calcium phosphate scaffold in irradiated bone

A comparison between bone reconstruction following the use of mesenchymal stem cells and total bone marrow in association with calcium phosphate scaffold in irradiated bone

Variation in the Repair of a Rib Graft used for Mandibular Reconstruction after 20 years

Diagnostic and prognostic value of 99mTc-tetrofosmin scintigraphy in maxillofacial flaps

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