A microvascular replantation of an amputated large facial segment, using a segment of the descending branch of the lateral circumflex femoral artery and its venae comitantes instead of interpositional vein grafts, is presented, and the advantages of this procedure are discussed.Q 1995 Wiley-Liss, Inc. MICROSURGERY 16:594-597 1995Replantation of amputated segments of the face is a challenging problem. Although the best cosmetic and functional results are obtained with replantation of severed tissue using microsurgical arterial and venous anastomoses, only a few successful cases have been reported so far.'p6 This is due mainly to the small size of the vessels to be anastomosed. We report a case of successful replantation of a completely amputated large facial segment using the vascular tree of the descending branch of the lateral circumflex femoral artery and its venae comitantes instead of interpositional vein grafts. CASE REPORTA 79-year-old man sustained a complete amputation of the whole nose, upper lip, and cheek skin when the blade of a grass cutting machine hit a rock on the ground and rebounded on his face. He was immediately transferred to the hospital, together with the amputated facial segment. The piece measured approximately 10 x 8 cm and was composed of the entire nose, full thickness of the upper lip, and the skin of the right cheek. The septa1 cartilage and part of the nasal bone were also included in the segment, as well as the vestibular skin and the mucous membrane (Figs. 1, 2 ) . After hemostasis of the facial wound was achieved, replantation of the amputated facial segment was attempted by a young plastic surgeon who is unfamiliar with microsurgery. Six hours after injury, the superior labial artery was anas- tomosed and the segment turned pink in color. However, veins suitable for anastomosis could not be found in the segment and complete obstruction of the arterial anastomosis developed soon after. Surgery was stopped then to evaluate the patient's general condition and the plastic surgeon asked our department for help.On our arrival, 11 hr after injury, replantation was started again with the consent of the patient's family. During the induction of general anesthesia, bench microdissection of the segment was performed to identify vessels suitable for anastomosis. The segment was irrigated with saline solution containing heparin and urokinase through the superior labial artery (1.0 mm in diameter), located at the right lateral aspect of the upper lip, and two veins, which were believed to be the right and left angular veins (0.6 to 0.8 mm in diameter), were identified at the root of the nose. The ischemic time was more than 12 hr. Therefore, arterial inflow was established first by anastomosing the superior labial artery of the amputated segment to the descending branch of the lateral circumflex femoral artery. After releasing the vascular clamp, the segment immediately turned pink and brisk bleeding from the edge was noted. Subsequently, venous anastomoses were performed between the two angu...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2025 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.