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A Novel Microsurgical Model for Heterotopic, En Bloc Chest Wall, Thymus, and Heart Transplantation in Mice
Published on: January 23, 2016
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Microsurgical reconstruction of complex maxillofacial gunshot wounds: Outcomes analysis and algorithm
Raffi Gurunluoglu1, James Gatherwright2
1Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio.
Microsurgery
|January 25, 2019
Summary
Microsurgery for maxillofacial gunshot wounds (GSW) shows favorable outcomes, with 70% returning to work and 58% satisfied. This study developed microsurgical algorithms for complex GSW reconstruction.
Area of Science:
- Reconstructive surgery
- Microsurgery
- Trauma surgery
Background:
- Outcomes of microsurgical reconstruction for maxillofacial gunshot wounds (GSW) are not well-documented.
- Key outcomes include appearance, function (speech, swallowing), and return to work.
- Microsurgical algorithms for complex GSW are needed.
Purpose of the Study:
- To report functional and aesthetic outcomes after microsurgical reconstruction for maxillofacial GSW.
- To develop microsurgical algorithms for complex maxillofacial GSW reconstruction.
Main Methods:
- Analysis of 42 consecutive maxillofacial GSW patients (2006-2014).
- Details of flap types used for reconstruction (e.g., fibula, radial forearm, scapular, gracilis, rectus abdominis, anterolateral thigh).
- Assessment of outcomes including flap survival, return to work/school, patient satisfaction, speech, swallowing, and oral competence.
Main Results:
- 36 free flaps were used for early reconstruction in 24 patients.
- Flap success rate was high, with only three partial skin paddle losses.
- Functional outcomes were positive: 70% return to work/school, 58% satisfaction, perceptible speech in most, no swallowing difficulties, and oral competence achieved.
Conclusions:
- Microsurgical reconstruction yields favorable outcomes for maxillofacial GSW.
- Developed microsurgical algorithms can guide clinical practice for complex mandible, lower lip, maxilla, and mid-face defects.
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