Free vascularised iliac crest graft: An audit of 26 consecutive cases
Over an 18 month period 26 vascularised myo-osseus, and one myo-osseus-cutaneous iliac crest flaps were used to reconstruct 18 mandibular and eight maxillary defects. During the operation one flap failed to reperfuse and was removed. Postoperatively three patients were returned to theatre for appraisal and reanastomoses, which in two cases involved thrombolysis. In all three salvage was deemed successful but in all there was partial muscle necrosis. There were 10 cases of anaesthesia of the skin supplied by the lateral cutaneous nerve of the thigh, three incisional hernias, one wound dehiscence in the thigh, two oronasal fistulas, one wound dehiscence in the neck, one infection by methicillin resistant Staphylococcus aureus in the thigh, and two long-term and one medium-term disturbances of gait. Complications were graded as severe (4%), intermediate (27%), and minor (46%).
Available from: Luis Capitán
[Show abstract] [Hide abstract]
ABSTRACT: Fourteen monoclonal antibodies (mAbs) were produced against a strain of Acanthamoeba castellanii isolated from a human cornea. The reactivity of the mAbs to reference strains of Acanthamoeba was examined by an indirect fluorescence antibody test (IFA) and Western immunoblot analysis. Nine mAbs reacted specifically with a known pathogenic reference strain of A. castellanii, but not with a non-pathogenic strain or other Acanthamoeba spp. The antigen recognized by these mAbs had a molecular mass of 17 kDa. The remaining five mAbs reacted with A. castellanii and A. polyphaga, members of group II (Pussard and Pons) but not with A. astronyxis (group I) or A. culbertsoni (group III). Western immunoblot analysis revealed that the latter mAbs stained many protein bands ranging from 30 to 150 kDa. None of the 14 mAbs reacted with Naegleria gruberi, N. fowleri, or Entamoeba histolytica. These observations suggest that an antigen common in group II as well as a pathogenic A. castellanii-specific antigen are present. Slot blot reactivity was comparable to the IFA. Under certain circumstances, therefore, slot blot analysis with a panel of mAbs should be helpful in the detection of keratitis-producing strains of Acanthamoeba.
[Show abstract] [Hide abstract]
ABSTRACT: To review complications and outcomes associated with latissimus-serratus-rib free flap oromandibular and midface reconstruction.
Retrospective medical record review.
Two academic tertiary care medical centers.
Twenty-eight patients with segmental resection of the mandible and 1 patient with combined resection of the mandible and maxilla after excision of neoplasms of the oral cavity, who were believed to be poor candidates for fibula free flap reconstruction, were identified.
Twenty-seven latissimus-serratus-rib osteomusculocutaneous free flap reconstructions and 2 serratus-rib osteomuscular free flap reconstructions were performed.
The outcome of microvascular free tissue transfer as well as short- and long-term complications were recorded.
There were no perioperative free flap failures. Delayed partial rib graft resorption occurred in 1 patient 33 months after free flap transfer for maxillary reconstruction. Among 28 cases of mandibular reconstruction, 1 case of bone graft nonunion was noted after a postoperative period of 57 months. All other cases achieved successful restoration of mandibular continuity. Donor site morbidity was well-tolerated in all patients.
Latissimus-serratus-rib osteomusculocutaneous free flaps are effective for reconstruction of composite defects of the mandible in patients who are not candidates for more commonly used vascularized bone-containing free flaps.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.