Journal of reconstructive microsurgery
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J Reconstr Microsurg · Nov 1993
Clinical TrialDouble vascularized fibulas for reconstruction of large tibial defects.
Vascularized fibular grafts have proven to have many advantages over nonvascularized transplants for treatment of large segmental bone defects in the extremities. Fibulas are typically impacted into the medullary canal and fixed with wires or screws. Consolidation has often been delayed and full weightbearing was only possible after graft hypertrophy, usually 12 to 18 months after reconstruction. ⋯ In six patients, healing was uneventful. In one patient, hypoperfusion of the lower extremity and the vascularized grafts eventually resulted in a below-knee amputation. In all six successful cases, union resulted within 3 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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J Reconstr Microsurg · Nov 1993
Vascularized nerve tube: an experimental alternative for vascularized nerve grafts over short gaps.
Multilayered tubes fabricated from human amnion were placed subcutaneously and/or longitudinally in contact with an axial artery and vein in rats. Histologic evaluation at the third postoperative week showed that the tubes had incorporated with the surrounding fibrovascular tissue. New capillary formation within the tube wall was well demonstrated by microangiography. ⋯ After 3 months, nerve regeneration was assessed using morphometric analysis. The vascularized amnion conduits showed comparable nerve regeneration to vascularized nerve grafts (p > 0.05), and superior nerve regeneration when compared to nonvascularized amnion conduits and nonvascularized nerve grafts as well (p < 0.05). This suggests that, in the rat model, a conduit can be neovascularized and used as a prefabricated tissue, to bridge short nerve gaps in a compromised bed.