Microvascular replantation of head and neck amputated parts: A systematic review

Efanov, Johnny Ionut; Montoya, Ixchel J.; Huang, Ke; Guertin, Charles; Harris, Patrick G.; Bou-Merhi, J.; Danino, A.

doi:10.1002/micr.30182

Cited by 9 publications

(10 citation statements)

References 21 publications

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“…In particular, microsurgery is found to be effective for repairing avulsion wounds. [7][8][9][10][11]. For scalp replantation, early microsurgery is recommended.…”

Section: Discussionmentioning

confidence: 99%

Emergency microsurgery for patients with soft tissue, skull, and dura complex defects after trauma: a case report

Okochi

Komuro

2019

Case Reports in Plastic Surgery and Hand Surgery

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“…In particular, microsurgery is found to be effective for repairing avulsion wounds. [7][8][9][10][11]. For scalp replantation, early microsurgery is recommended.…”

Section: Discussionmentioning

confidence: 99%

Emergency microsurgery for patients with soft tissue, skull, and dura complex defects after trauma: a case report

Okochi

Komuro

2019

Case Reports in Plastic Surgery and Hand Surgery

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“…Pit bull terriers are the most common identified breed in dog bites requiring surgical repair, and are also more likely to cause more severe injuries than other dog breeds (Garvey, Twitchell, Ragar, Egan, & Jamshidi, ; Golinko et al, ; Kaye et al, ; O'Brien et al, ). There have been many published reports of tissue replantation in various head and neck sites and a recent systematic review identified 208 such cases (Efanov et al, ). However, only 1 case involved the mid‐face and while the size of the replantation was large, both artery and vein were anastomosed (Cooney, Flether, & Bonawitz, ).…”

Section: Discussionmentioning

confidence: 99%

Microvascular replantation of a composite facial avulsion in a 24‐month‐old child after dog bite

et al. 2017

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Dog bite injuries are common sources of morbidity with an estimated incidence of 4.5 million bites per year with over 350,000 requiring treatment in the emergency room. Children under the age of 14 are most likely to be affected with a peak age of 5-9 years old. We report a case of a 24-month-old female who sustained a large composite facial avulsion injury from a pit bull dog bite. The avulsed tissue involved a substantial portion of the patient's mid-face, including the entire soft tissue of the nose, upper lip, part of the left cheek, and left oral commissure. Artery-only microvascular replantation was performed because no recipient vein could be identified from the facial defect. Medicinal leech therapy was used for eight days postoperatively to prevent venous congestion. The patient experienced significant blood loss due to leech therapy and required nearly 29 L of blood product replacement. At the last follow up of 8 months postoperatively, the patient was recovering well with significant improvement in function and cosmesis of the mid-face. This case describes a successful artery-only replantation of an avulsive bite injury to the face of a young child. Despite the technical difficulty of cases such as this one, microvascular replantation should be attempted because when successful it provides a superior cosmetic and functional result to other reconstructive techniques.

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“…In the specific case of lip amputation, microsurgical replantation has the potential for superior aesthetic outcomes as well as restoration of sensory and motor function. Since James reported successful microsurgical replantation of the lip in 1976, there have only been 21 cases reported, four of which were due to human bites [1][2][3][4][5][6]. Due to the paucity of reports on this, complications are likely to be underreported.…”

Section: Introductionmentioning

confidence: 99%

Complications of Microvascular Upper Lip and Free Grafted Nasal and Eyebrow Replantation After Assault via Human Bite

Leach¹,

Lundberg²,

Holcombe³

2019

Cureus

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Amputation of facial soft tissue, particularly avulsion due to human bite, is an uncommon injury that has severe cosmetic and functional implications. Microsurgical replantation has the potential for superior aesthetic outcomes and restoration of function. We report a case of a 46-year-old male who sustained avulsion injuries from human bites, which included portions of his eyebrow, nose, and upper lip. Artery and vein microvascular replantation was performed on the upper lip. The amputated eyebrow and nasal segments were replanted in a similar fashion to a skin graft. On post-operation day 1, our patient suffered an ischemic stroke followed by a myocardial infarction requiring systemic tissue plasminogen activator (tPA) treatment. Following administration of tPA, there was continuous bloody discharge from the replant sites and the eyebrow, nose, and upper lip began to appear increasingly dusky. Our patient was determined to be a high-risk candidate for immediate revision surgery and he subsequently underwent a six-stage secondary reconstruction. At his most recent four-month follow-up, our patient is satisfied with his cosmetic and functional outcomes. This was a case of failed microvascular upper lip replantation and eyebrow and nasal replacement complicated by stroke and myocardial infarction. The authors review the common complications in replantation, particularly pertaining to upper lip reanastamosis, and discuss a potential novel complication encountered in this case relevant to both free graft and microvascular replantation.

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Microvascular replantation of head and neck amputated parts: A systematic review

Cited by 9 publications

References 21 publications

Emergency microsurgery for patients with soft tissue, skull, and dura complex defects after trauma: a case report

Emergency microsurgery for patients with soft tissue, skull, and dura complex defects after trauma: a case report

Microvascular replantation of a composite facial avulsion in a 24‐month‐old child after dog bite

Complications of Microvascular Upper Lip and Free Grafted Nasal and Eyebrow Replantation After Assault via Human Bite

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