Microvascular reconstruction of composite cranial defects.

Area of Science:

• Plastic Surgery
• Craniofacial Surgery
• Microsurgery

Background:

• Microvascular reconstruction of composite cranium defects presents significant surgical challenges.
• Operative planning for cranial defects varies based on specific anatomical regions.

Purpose of the Study:

• To outline detailed surgical strategies for microvascular reconstruction across different cranial areas.
• To provide insights into planning microvascular reconstruction for diverse cranial defect locations.

Main Methods:

• Analysis of 58 free tissue transfers in 54 patients with composite cranial defects (1995-2009).
• Cranial defects classified into six zones for targeted surgical planning.
• Review of patient demographics, defect etiology, surgical techniques, and complications.

Main Results:

• Most defects (45 patients) resulted from ablative procedures; others were posttraumatic (8) or congenital (1).
• Nine distinct flap types were employed, with recipient vessel selection and vein graft use adapted to defect site.
• Microsurgical reconstruction demonstrated safe and predictable outcomes.

Conclusions:

• Methodic problem assessment and meticulous planning are crucial for successful microvascular cranial reconstruction.
• Effective strategies exist for planning microvascular reconstruction in various cranial defect areas.
• Safe and predictable outcomes are achievable with careful attention to reconstructive details.