[Topographic-anatomic study of tissue transplants of the inguinal region]

Analysis of intraoral microvascular anastomosis in maxillofacial defects reconstruction

This review summarizes the research progress in the field of intraoral microvascular anastomosis techniques (IAT) and attempts to investigate the indications for procedures in which IAT can be applied, the surgical procedure and the difficulties involved, technical assessments, result evaluation and the perspective. Currently, microvascular anastomosis technique is widely used in maxillofacial defects reconstruction from various causes including cutaneous injury or congenital deformity which usually required extensive flap reconstruction and therefore a vascular free flap is routinely used. Conventional microvascular anastomosis reconstruction techniques cannot avoid new incisions, which will affect the postoperative aesthetic situation. Surgeons have therefore attempted to improve this technique to effectively eliminate scars caused by surgery: some patients can be chosen to undergo microvascular anastomosis of the free flap intraorally, thus reducing the extraoral incision caused by the anastomosis located in neck or maxillofacial improving the postoperative appearance of the patients. In addition to preserving the external appearance, intraoral anastomosis technique (IAT) can also solve some other problems of maxillofacial vascular anastomosis, such as insufficient vessel pedicle length and high risk of facial nerve injury.

Free microvascular transfer of segmental corticocancellous femur for reconstruction of the alveolar ridge

In seven patients with deficiency of the alveolar ridge of the maxilla or mandible the defect was covered with the help of a microvascular corticocancellous transplant of femur. The defects to be corrected measured 3-10 cm long, 1.5-4 cm wide, and 1-1.5 cm high. The microvascular pedicle was between 4 and 10 cm long. The descending genicular artery was anastomosed to the facial or labial superior artery and the accompanying veins accordingly. There were no serious complications and no transplant was lost. In all patients the defect was covered by the correct size and design. All patients were treated with dental implants six months after successful reconstruction of the ridge. The microvascular osteoperiosteal femur transplant can be used successfully in individual reconstruction of segmental defects of the alveolar ridge.

Vascularized pedicled iliac crest graft for selected total hip acetabular reconstructions: a cadaver study

Bone grafting is an essential part of most total hip acetabular reconstructions. There are a limited number of surgical options, each with inherent disadvantages for the management of structural acetabular defects. In this cadaver study, the authors aimed to evaluate the availability of vascularized pedicled iliac crest graft for the purpose of acetabular reconstruction. The hip joints, ilia and deep circumflex iliac artery pedicles of six adult preserved cadavers were dissected bilaterally. A segment of the iliac crest was elevated on the vascular pedicle and its access to different parts of the acetabulum was evaluated. The average pedicle length was sufficient for coverage of the superior and anterior acetabular walls. The access to the posterior wall, however, required modification of the bone size. A vascularized pedicled iliac crest graft is suitable for the reconstruction of selected acetabular deficiencies.