Microsurgery
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Review
Face transplantation surgical options and open problems in cadaveric models: a review article.
Being first conceptualized in 2005-2006, total face transplantation is now a clinical reconstructive option in the treatment of patients with acquired facial deformity. The authors propose a review on the status of total face transplantation based on their clinical experience in dealing with traditional microsurgical head and neck reconstructions and on the basis of their published pre-clinical research investigating technical aspects of the facial allotransplantation procedure in cadaveric models. The authors first discuss the harvesting options and propose two facial flaps which address different reconstructive needs. ⋯ Finally, the authors address the major technical challenges associated with transplanting the most complex osteomyocutaneous allograft. Significant improvement has been made in the field of vascularized composite tissue allotransplantation over the last 5-6 years. The results of the 13 face transplants performed worldwide are encouraging both functionally and aesthetically, when compared with traditional reconstructive procedures.
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Composite defects of bone and soft tissues represent a reconstructive challenge. Several techniques have been described in the medical literature; however, extensive composite defects should be reconstructed with microvascular free tissue transfer. The purpose of this report is to present the use of a composite latissimus dorsi and serratus anterior and rib free flap (LD-SA/rib) as an alternative procedure in patients who cannot undergo more commonly used vascularized bone-containing free flap reconstruction. ⋯ LD-SA/rib free flap should be regarded as an effective procedure for reconstruction of composite tissue defects in patients who are not candidates for more commonly used vascularized bone-containing free flaps.