Abstract:
BACKGROUND: Face transplantation is a demanding operation requiring complex planning and expert technical performance. While the documentation of successes of the first transplants is impressive, there are lacunae in reporting of institutional protocols for other critical operation components, namely, immunosuppression, graft surveillance, and management of rejection and graft failure. The purpose of this review is to assess protocol reporting by face transplant teams to determine where we, as a plastic surgery community, can improve. METHODS: A systematic review of PubMed was conducted to identify literature on face transplants published from November, 2005, starting with the first successful transplant to December, 2018. English-language articles were reviewed for reporting of protocols on antimicrobial prophylaxis, immunosuppression, graft surveillance, and management of rejection and graft failure. RESULTS: A total of 44 face transplantation patients were identified. Protocols for antimicrobial prophylaxis, immunosuppressive induction, and maintenance immunosuppression were reported for 61%, 75%, and 73% of patients, respectively. Protocols for graft surveillance and medical management of rejection were reported for 70% of patients in both cases. Surgical salvage strategies to manage graft failure were documented for 43% of patients. CONCLUSION: The current literature on face transplantation does not include consistent reporting on critical aspects of patient care. Medical protocols outlining guidelines for immunosuppression, graft surveillance, and management of rejection and graft failure are the most critical factors determining overall transplant success. However, they are underreported in the literature. Development and communication of standardized protocols is essential to improve patient outcomes and maximize the results of this procedure.
journal_name
J Reconstr Microsurgjournal_title
Journal of reconstructive microsurgeryauthors
Daneshgaran G,Stern CS,Garfein ESdoi
10.1055/s-0039-1691787subject
Has Abstractpub_date
2019-11-01 00:00:00pages
652-661issue
9eissn
0743-684Xissn
1098-8947journal_volume
35pub_type
杂志文章abstract::The spinal cord cannot heal after severance because the central nervous system is "non-permissive" to the advancement of axons that regrow from presynaptic motoneurons. With the aim of overcoming paraplegia, the author has carried out extensive experimental research since 1980, first in rats and subsequently in monkey...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2001-18873
更新日期:2001-11-01 00:00:00
abstract::Microsurgical treatment of ring avulsion injuries is often difficult, due to widespread intimal damage of the digital vascular bundles. Thirty-one patients with such injuries in varying degrees were treated during the period 1986 to 1992: of these, 15 underwent microsurgical revascularization. In addition to the tradi...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006475
更新日期:1996-04-01 00:00:00
abstract::The subject of ischemia-reperfusion has commonly been studied in rat hindlimb models. Unfortunately, in these experiments, the ischemia procedures lack standardization. For this reason, the authors evaluated the reliability of rat ischemia models described in the literature using scintigraphy. The study comprised six ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-830005
更新日期:2004-07-01 00:00:00
abstract::This study examined the efficacy of gene therapy on wound healing. The authors investigated whether delivery of the gene encoding a particular cytokine, known to be important in angiogenesis, could affect ischemic skin flaps. Anterior abdominal skin flaps, based solely on the epigastric artery and vein, were created i...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000196
更新日期:1998-08-01 00:00:00
abstract::Composite tissue transplantation has emerged as a viable alternative to prosthetics and complex reconstructive surgery. Thus far it is reserved for cases which cannot be effectively reconstructed and where it offers some benefits over prostheses. It has been used in the upper extremity with encouraging results and, mo...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2006-939928
更新日期:2006-05-01 00:00:00
abstract::This study used quantitative PCR in the murine model to compare the ability of a limb allograft vs. a comparable dose of marrow suspension to induce chimerism. Female C57Bl/6 mice received a vascularized hindlimb allograft, a comparable dose of 5 x 10 (6) donor bone marrow cells, or a standard dose (20 x 10 (6)) of ma...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2006-946716
更新日期:2006-07-01 00:00:00
abstract::Although many trauma centers are primarily "adult-oriented," the presentation of unusual life- or limb-threatening wounds in children occasionally have mandated urgent microvascular tissue transfer for salvage. For these rare instances, should a microsurgical team accustomed to dealing with adult trauma patients even ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006526
更新日期:1995-05-01 00:00:00
abstract::Endorectal ileo-anal anastomosis has become a mainstay of continent bowel reconstruction after total colectomy. However, the procedure is often aborted because of lack of vessel length for the formation of the ileal pouch. The use of microsurgical techniques to lengthen mesenteric vessels and to allow completion of th...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006944
更新日期:1988-10-01 00:00:00
abstract::The free radial forearm flap is a very common material for penile reconstruction. Its major problems are donor-site morbidity with large depressive scar after skin grafting, urethral fistula due to insufficiency of suture line for the urethra, and need for microvascular anastomosis. A new method using combined bilater...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2006-939957
更新日期:2006-04-01 00:00:00
abstract::Radical resection of tongue and oropharyngeal carcinomas often results in complex defects that are challenging to reconstruct. Furthermore, remaining function should not be disturbed by the reconstruction. We introduce a new flap design and monitored swallowing and speech following reconstruction of complex oral defec...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2008-1078691
更新日期:2008-04-01 00:00:00
abstract::In recent years microvascular free tissue transfer has become a well accepted reconstructive technique. The current trend in flap research seems to be the development of more refined flaps to meet specific needs with minimal donor site morbidity. The internal oblique muscle provides a broad, thin, well-vascularized fl...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1007012
更新日期:1986-01-01 00:00:00
abstract::Tissue expansion in combination with flap transfer has been widely reported as preexpansion of flaps, but only once as expansion of a free flap after transfer. Three free flaps and one pedicled flap were expanded after transfer. Indication, timing of expander implantation and explantation, technical aspects, and compl...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-970184
更新日期:2007-02-01 00:00:00
abstract::The anatomy of the ascending branch of the deep circumflex iliac vessels is reported. This vasculature allows the design of a musculoperitoneal flap, not exceeding 7 cm x 14 cm, together with an osteomusculocutaneous groin flap. The procedure is particularly useful, if resection of an intraoral carcinoma has included ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006848
更新日期:1989-01-01 00:00:00
abstract::Controversy surrounds the question whether free flaps remain dependent for blood supply on their vascular pedicle or if there is an autonomization by neovascularization from the surrounding wound bed. This becomes important when flap shaping or repositioning are performed. Our study involved 23 patients who received a...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0028-1103500
更新日期:2009-02-01 00:00:00
abstract::A case of degloving injury of the whole hand reconstructed by a combination of an anterolateral thigh (ALT) flap and a groin flap applied as a pedicled distant flap was reported. Despite complications of congestion of the ALT flap and superficial infection, both flaps were severed at 4 weeks after transplantation, and...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0031-1278708
更新日期:2011-06-01 00:00:00
abstract::An expanded latissimus dorsi flap (expanded LD flap) was transferred in two patients with severe post-burn neck contracture. Free flaps created using standard techniques are of limited size and sometimes cannot cover the defect after excision of scar tissue, particularly when a severe burn scar extends to the facial r...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2002-33018
更新日期:2002-07-01 00:00:00
abstract::Phyllodes tumors (PTs) are uncommon fibroepithelial tumors of the breast, noteworthy for their difficult excisions and high recurrence rates. In the setting of recurrence, there is no consensus in the literature as to the extent of excision or the impact on reconstructive options. Breast-conserving surgery and simple ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1275493
更新日期:2011-05-01 00:00:00
abstract::Vascularized bone allografts (VBAs) could be useful adjuncts to the clinical reconstructive surgeon's arsenal. These grafts are known experimentally to be subject to host rejection. One way to control the rejection problem would be to develop specific immune unresponsiveness via host conditioning. Using a proven relia...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006992
更新日期:1987-04-01 00:00:00
abstract::The etiopathology, clinical features, and treatment of carpal tunnel syndrome (CTS) in long-term hemodialyzed patients, are discussed in the light of new clinical findings. Conclusions summarizing the specific characteristics of CTS in hemodialyzed patients include the following. 1) There is a relatively equal sex rat...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006856
更新日期:1989-04-01 00:00:00
abstract::This is the first report of an iatrogenic arteriovenous fistula complicating revascularization of an incomplete amputation of the hand, due to inadvertent anastomosis of the proximal radial artery to the distal cephalic vein. This resulted in a severely painful, massively swollen hand, which was initially diagnosed as...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2005-871767
更新日期:2005-07-01 00:00:00
abstract::A retrospective evaluation of the functional results after reconstructive treatment with levator scapulae transfer and scapulo-spinal fasciodesis by fascia lata slings for complete chronic trapezius palsy is presented. Five patients (ages 6 to 40 years) were operated on between 1988 and 1991 because of incapacitating ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006544
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Locally advanced breast cancer (LABC) and chest wall osteoradionecrosis (ORN) often require extensive and composite tissue resection, including muscles, ribs, pleura, and lung parenchyma. As such, these cases necessitate complex reconstructive procedures for skeletal chest wall reconstruction and soft tissue...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0035-1563395
更新日期:2016-02-01 00:00:00
abstract::The high demand for microsurgical skills in those without a strong microsurgery background limits the application of the rat aortic transplant model to transplantation research. In this study, we established a rat aortic transplant model using a hydrodissection technique as a minimal-touch technique in vessel dissecti...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0031-1278710
更新日期:2011-07-01 00:00:00
abstract::The free extended lateral arm flap (ELAF) has gained increasing popularity thank to its slimness and versatility, longer neurovascular pedicle, and greater flap size when compared with the original flap design. The aim of this study was to assess the donor-site morbidity associated with this extended procedure. A retr...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0031-1289165
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:The authors presented their clinical experience and demonstrated surgical methods for reconstructing complex bone and soft tissue defects of the hand by using modified chimeric radial collateral artery perforator flaps. METHODS:Surgical procedures that employed 16 modified chimeric radial collateral artery ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0034-1390324
更新日期:2015-03-01 00:00:00
abstract::Background Although flap transfer is a popular reconstructive procedure with a high success rate, it is associated with a high complication rate and low salvage rate. During the past decade, negative-pressure wound therapy (NPWT) has been increasingly applied to facilitate flap transfer and salvage flaps threatened by...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1599076
更新日期:2017-06-01 00:00:00
abstract::Considerable controversy persists regarding the optimal technique for hypopharyngeal reconstruction. The ideal procedure should provide low mortality and morbidity, short hospitalization, a high success rate, few complications, and the greatest potential for neopharyngeal speech and deglutition. In this study, a varie...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2002-19702
更新日期:2002-01-01 00:00:00
abstract::A retrospective review of 11 patients with complex and massive lower-limb defects requiring multiple transfers and/or regional muscle flaps for closure, found that microvascular transfers achieved final wound closure, either alone or in concert with local flaps, in all but one case. A local flap alone was not sufficie...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000160
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND: The volume of the profunda femoris artery perforator (PAP) flap limits its indications to small- and medium-sized breast reconstructions after modified radical mastectomy for cancer. We report a modified PAP flap design, including not only a vertical extension that increases its volume but also the skin sur...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0038-1649508
更新日期:2019-01-01 00:00:00
abstract::Segmental defects of the distal femur following trauma pose a reconstructive challenge. A stable reconstruction capable of withstanding high forces while allowing early mobility is paramount. The Capanna technique of reconstruction combining allograft with vascularized bone graft provides such a construct and has been...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0031-1281520
更新日期:2011-07-01 00:00:00