Salvage of postcranioplasty implant exposure using free tissue transfer

Abstract

Free tissue transfer should be considered as the preferred reconstructive option for postcranioplasty exposed implant salvage. High rate of implant salvage (>90%) is possible even with chronic implant exposure (>3 months).

Reconstruction of cranioplasty using the thoracodorsal artery perforator (TDAP) flap: A case series

“…Alloplastics are more likely to suffer from infection and show higher rates of implant exposure (Reddy et al, ). However, a meta‐analysis dealing of infections in cranioplasty did not show differences between alloplastic and autologous reconstructions (Chou et al, ; Yadla et al, ). Prosthetic materials can be custom‐made to the defect and they are considered structural stable (Sosin, De la Cruz, et al, ).…”

“…In old or in oncological patients, the surrounding skin could have been previously irradiated or sun damaged, and these conditions have been shown to be risk factors for flap failure (Ibrahim, Santiago, Huang, Manson, & Gordon, ). Chou stated that local flaps may fail even with a small defect (1 × 1 cm 2 ) and a failure of a local flap will require a much more challenging secondary reconstruction, because the implant exposure will lead to prosthesis' infection and subsequent removal (Chou et al, ). For all the aforementioned reasons, free‐flap reconstruction is widespread accepted as the first option in soft‐tissue coverage.…”

“…Cranioplasty can be performed with bone auto or allograft and metal or nonmetal alloplasts (Aydin, Kucukyuruk, Abuzayed, Aydin, & Sanus, ; Reddy et al, ). In case of those large defects, microsurgical reconstruction is considered the gold standard, although free‐flap scalp reconstruction remains challenging compared to the other regions in head and neck reconstruction (Chou et al, ). The most common flaps for soft‐tissue coverage after alloplastic cranioplasty are the latissimus dorsi (LD), the anterolateral thigh (ALT), the parascapular flaps (Larrañaga, Rios, Franciosi, Mazzaro, & Figari, ; Reddy et al, ; Sosin, De la Cruz, et al, ).…”

Comparison of the outcomes between free anteromedial thigh flap and anterolateral thigh flap in head and neck cancer reconstruction: Analysis of propensity‐score‐matched patient cohorts

“…In the literature, most studies used the AMT flap as an alternative reconstruction option when the ALT flap is unavailable (Hsieh et al, 2009; Katre, Shaw, Batstone, & Brown, 2008; Namgoong et al, 2018). With increasing experience, the AMT flaps have become even more frequently used as the reconstruction option (Chou et al, 2017; Liang et al, 2013; Riva et al, 2013; Scaglioni et al, 2018).…”

Fallbericht einer Frontobasisrekonstruktion und Volumenkorrektur durch freie M. gracilis-Lappenplastik und autologe Fett-Transplantation – Die Lappenplastik als Scaffold für eine Fettgewebe-Transplantation

“…Auch in Fällen freiliegender Implantate wird zur adäquaten Weichteildeckung und Polsterung des Implantats die Verwendung von freien Lappenplastiken empfohlen. Chou et al konnten dadurch bei über 3 Monaten freiliegenden Implantaten einen Implantatausbau verhindern und eine Defektdeckung erreichen [22].…”