Advanced cranial reconstruction using intracranial free flaps and cranial bone grafts: an algorithmic approach developed from the modern battlefield.

Abstract:

BACKGROUND:The objective of this study was to report outcomes after initiation of an algorithmic approach (Bethesda protocol) using intracranial free flaps, cranial bone autografts, and dermal/fat grafts to treat warfare-related cranial frontofacial defects after war-related decompressive craniectomy. METHODS:A retrospective review of personnel undergoing complex cranial defect reconstruction that required free flap interpositions for dead space obliteration, cranial bone grafting, or dermal/fat grafting for orbital defects was performed over a 52-month period. RESULTS:From March of 2003 to July of 2011, 13 patients were identified who underwent complex craniofacial defect reconstruction. All patients were male (average age, 25 years). Average follow-up was 3.6 years. Glasgow Coma Scale score was 7 initially and 9 on arrival to the continental United States. Average evacuation time was 4.2 days. Forty-six percent of injuries were blast injuries. Nine patients (69 percent) underwent hemicraniectomies and four (31 percent) underwent bifrontal craniectomies. Two patients required free flaps and four required free flaps and cranial bone grafts for skull base reconstruction. Five patients required cranial bone grafts and two required cranial bone grafts with dermal fat grafts for reconstruction. All patients were complication free at conclusion of the study. The initial free flap success rate was 86 percent (six of seven flaps). Successful frontal bar/free flap reconstruction was present in 100 percent and the secondary cranioplasty rate was 77 percent. CONCLUSION:Decompressive craniectomy defects associated with orbital, sinus, and skull base defects can be successfully reconstructed using an algorithmic approach with low morbidity and high secondary cranioplasty retention rates. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.

journal_name

Plast Reconstr Surg

authors

Kumar AR,Tantawi D,Armonda R,Valerio I

doi

10.1097/PRS.0b013e318267d5cb

subject

Has Abstract

pub_date

2012-11-01 00:00:00

pages

1101-1109

issue

5

eissn

0032-1052

issn

1529-4242

pii

00006534-201211000-00022

journal_volume

130

pub_type

杂志文章
  • Voice reconstruction with free ileocolon flap transfer: implications for the lower respiratory tract.

    abstract:BACKGROUND:Free ileocolon flap surgery is an effective technique for voice reconstruction in hypopharyngolaryngectomy defects. A tracheoesophageal fistula is created using an intestinal conduit characterized by secretions and a resident microbial flora. The aim of this study was to investigate the respiratory complicat...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e31820cf282

    authors: Rampazzo A,Gharb BB,di Spilimbergo SS,Chung KP,Chen HC

    更新日期:2011-05-01 00:00:00

  • Does the Organization of Plastic Surgery Units into Independent Departments Affect Academic Productivity?

    abstract:BACKGROUND:There is an increased push for plastic surgery units in the United States to become independent departments administered autonomously rather than as divisions of a multispecialty surgery department. The purpose of this research was to determine whether there are any quantifiable differences in the academic p...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000003772

    authors: Loewenstein SN,Duquette S,Valsangkar N,Avula U,Lad N,Socas J,Flores RL,Sood R,Koniaris LG

    更新日期:2017-11-01 00:00:00

  • The incidence of late cephalohematoma following craniofacial surgery.

    abstract:BACKGROUND:Cranial vault remodeling procedures are carried out for both syndromic and nonsyndromic craniosynostosis as well as to correct some acquired deformities of the cranial vault. These procedures improve not only cosmesis but also neurological symptoms. The purpose of this study was to determine the incidence of...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000277997.56941.e5

    authors: Ghali S,Knox KR,Boutros S,Thorne CH,McCarthy JG

    更新日期:2007-09-15 00:00:00

  • Experimental and clinical study on the vitality of orthotopic cartilage transplants.

    abstract::Orthotopic cartilage transplants are performed in the course of numerous rhinosurgical operations. Precondition of a permanent success of the operation is preservation of vitality of the transplanted cartilage. Although numerous study results of heterotopic cartilage transplants exist, corresponding examinations in or...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199504000-00007

    authors: Gubisch W,Greulich M,Donath K

    更新日期:1995-04-01 00:00:00

  • Structural fat grafting: more than a permanent filler.

    abstract::Grafted fat has many attributes of an ideal filler, but the results, like those of any procedure, are technique dependent. Fat grafting remains shrouded in the stigma of variable results experienced by most plastic surgeons when they first graft fat. However, many who originally reported failure eventually report succ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000234610.81672.e7

    authors: Coleman SR

    更新日期:2006-09-01 00:00:00

  • A novel mouse model of cutaneous radiation injury.

    abstract:BACKGROUND:Radiation therapy is a cornerstone of oncologic treatment. Skin tolerance is often the limiting factor in radiotherapy. To study these issues and create modalities for intervention, the authors developed a novel murine model of cutaneous radiation injury. METHODS:The dorsal skin was isolated using a low-pre...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181fed4f7

    authors: Thanik VD,Chang CC,Zoumalan RA,Lerman OZ,Allen RJ Jr,Nguyen PD,Warren SM,Coleman SR,Hazen A

    更新日期:2011-02-01 00:00:00

  • Island fasciocutaneous flap based on the proximal perforators of the radial artery for resurfacing of burned cubital fossa.

    abstract::In the vast majority of burned patients, the injury is limited to the skin and superficial subcutaneous tissue, and the vasculature of the deeper fascia is spared. This fact encouraged me to design a flap in which the burned scar tissue is employed. The island fasciocutaneous flap is based only on the proximal septocu...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199709001-00014

    authors: el-Khatib HA

    更新日期:1997-09-01 00:00:00

  • Patient satisfaction following nipple-sparing mastectomy and immediate breast reconstruction: an 8-year outcome study.

    abstract:BACKGROUND:Nipple-sparing mastectomy has become an accepted treatment for appropriately selected breast cancers. No reports have correlated patient satisfaction following nipple-sparing mastectomy with objective observer assessments. METHODS:From 2001 to 2008, nipple-sparing mastectomy and immediate reconstruction wer...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181ccdaa4

    authors: Djohan R,Gage E,Gatherwright J,Pavri S,Firouz J,Bernard S,Yetman R

    更新日期:2010-03-01 00:00:00

  • Vaginal reconstruction with gracilis myocutaneous flaps.

    abstract::The definition, history, experimental background, surgical technique, and clinical applications of compound gracilis myocutaneous flaps are presented. This flap has been our method of choice for neo-vaginal reconstruction after radical pelvic surgery. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-197608000-00006

    authors: McCraw JB,Massey FM,Shanklin KD,Horton CE

    更新日期:1976-08-01 00:00:00

  • Rhinoplasty: a simplified, three-stitch, open tip suture technique. Part I: primary rhinoplasty.

    abstract::Tip suture techniques offer a reliable and dramatic method of tip modification without needing to interrupt the alar rim strip or add tip grafts. The present simplified three-stitch technique consists of the following: (1) a strut suture to fix the columella strut between the crura, (2) bilateral domal creation suture...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199904050-00022

    authors: Daniel RK

    更新日期:1999-04-01 00:00:00

  • How Rheumatoid Arthritis Patients Make Decisions Regarding Hand Reconstruction: A Qualitative Study from the Silicone Arthroplasty in Rheumatoid Arthritis Project.

    abstract:BACKGROUND:Previous studies have determined specific factors influencing patients with rheumatoid arthritis to choose to undergo reconstructive hand surgery. However, little is known about how rheumatoid arthritis patients are counseled by physicians regarding surgical options and the concerns that cause patients to de...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/PRS.0000000000002083

    authors: Mathews AL,Burns PB,Chung KC

    更新日期:2016-05-01 00:00:00

  • The reverse-flow posterior tibial artery island flap: anatomic study and 72 clinical cases.

    abstract::Based on anatomic, dye injection, and angiography observations since 1984, 72 patients with tissue defects of the foot (due to injury or surgery) have been reconstructed using a reverse-flow posterior tibial artery island flap. In the 72 patients, etiology has included extensive crushing (40 patients), burn scars (10 ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Liu K,Li Z,Lin Y,Cao Y

    更新日期:1990-08-01 00:00:00

  • Mortality in patients with necrotizing fasciitis.

    abstract:BACKGROUND:The prognostic factors that determine outcome in patients with necrotizing fasciitis remain poorly understood. The aim of this study was to analyze the variables that affect the mortality and morbidity of patients with necrotizing fasciitis and to create a simple method for estimating the probability of mort...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000259040.71478.27

    authors: Golger A,Ching S,Goldsmith CH,Pennie RA,Bain JR

    更新日期:2007-05-01 00:00:00

  • Xeroradiography in the diagnosis of facial fractures.

    abstract::Xeroradiography, because of its unique phenomenon of "edge enhancement," has some advantages for assessing facial fractures. In 17 of the 19 patients in our pilot study group, this technique was as valuable as, or more so than, plain films. The xerogram done prior to laminagraphy is a useful "map" for the radiologist ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-197808000-00008

    authors: Marshall KA,Sadowsky NL,Sigman D

    更新日期:1978-08-01 00:00:00

  • The thoracodorsal artery perforator flap in the treatment of axillary hidradenitis suppurativa: effect on preservation of arm abduction.

    abstract:UNLABELLED:Hidradenitis suppurativa is a chronic, recurrent inflammatory disease of the skin characterized by abscesses and scars. The axillary region is predominantly affected, leading to limited mobility of the arm due to scar retraction. This prospective study aimed to analyze the surgical treatment of severe lesion...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3182268c38

    authors: Busnardo FF,Coltro PS,Olivan MV,Busnardo APV,Ferreira MC

    更新日期:2011-10-01 00:00:00

  • Comparison of the Pedicled Latissimus Dorsi Flap with Immediate Fat Transfer versus Abdominally Based Free Tissue Transfer for Breast Reconstruction.

    abstract:BACKGROUND:Abdominally based free tissue transfer (FTT) and latissimus dorsi and immediate fat transfer (LIFT) procedures are both fully autologous options for breast reconstruction. The former is specialized and requires comfort with microsurgical technique, whereas LIFT combines a common set of techniques familiar to...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000007027

    authors: Black CK,Zolper EG,Economides JM,Abadeer A,Fan KL,Song DH

    更新日期:2020-08-01 00:00:00

  • Cutaneous blood supply of the penis.

    abstract::Twelve male cadaver specimens were injected with a latex solution to define the cutaneous blood supply of the penis. The cutaneous blood supply of the penile shaft is derived solely from a pair of axial arteries running in the dartos layer. Additional deep perforating arteries from the dorsal penile artery and corpora...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198902000-00001

    authors: Grossman JA,Caldamone A,Khouri R,Kenna DM

    更新日期:1989-02-01 00:00:00

  • Congenital skin tube pedicle associated with the constriction band syndrome.

    abstract::A very rare case of congenital skin tube pedicle with congenital constriction band syndrome was presented. Only one report concerning this bizarre abnormality could be found in the available literature, and no consideration of its etiology has previously been published. In our case, the skin tube was accompanied by th...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199204000-00029

    authors: Nakamura K,Nanjyo B

    更新日期:1992-04-01 00:00:00

  • Uncircumcision: a historical review of preputial restoration.

    abstract::Throughout history, demands for restoration of the prepuce after circumcision were most commonly related to the political or religious persecution of the Jewish people. The first evidence for such a procedure is mentioned in the Bible: Under the reign of Antiochus IV (168 BC) Hellenistic ideals, such as public nakedne...

    journal_title:Plastic and reconstructive surgery

    pub_type: 历史文章,杂志文章

    doi:10.1097/00006534-199806000-00037

    authors: Schultheiss D,Truss MC,Stief CG,Jonas U

    更新日期:1998-06-01 00:00:00

  • Importance of the new position of the nipple-areola complex in breast augmentation surgery.

    abstract:BACKGROUND:When the results of breast augmentation surgery are evaluated, the respective points of view of the surgeon and the patient can differ. Because of the nature of plastic surgery, evaluation of the results puts more emphasis on the patient's satisfaction than on medical knowledge. Among the patients who are sa...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000246235.00439.3d

    authors: Youn ES

    更新日期:2006-12-01 00:00:00

  • Online patient resources for breast reconstruction: an analysis of readability.

    abstract:BACKGROUND:Online resources for health information are commonly used by many patients. The discrepancy between functional health literacy and available patient information is recognized as an important contributor to health disparities. To provide understandable patient information, the National Institutes of Health an...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000000472

    authors: Vargas CR,Koolen PGL,Chuang DJ,Ganor O,Lee BT

    更新日期:2014-09-01 00:00:00

  • Labial incompetence: a marker for progressive bone resorption in silastic chin augmentation.

    abstract::Bone erosion below silicone rubber implants is a wellknown sequela, occurring in a majority of patients undergoing augmentation genioplasty. It is generally considered to be self-limiting and with minimal adverse consequences. However, if bone erosion progresses to the extent to which teeth are jeopardized or alterati...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199611000-00012

    authors: Matarasso A,Elias AC,Elias RL

    更新日期:1996-11-01 00:00:00

  • The Pushback Pharyngeal Flap: An 18-Year Experience.

    abstract:BACKGROUND:The pharyngeal flap is one of the oldest and most popular techniques for correction of velopharyngeal insufficiency. The authors describe a large series using a technique that combines a pharyngeal flap with a palate pushback to avoid common causes of operative failure while restoring the velopharyngeal mech...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000005645

    authors: Rochlin DH,Mittermiller PA,Sheckter CC,Menard RM

    更新日期:2019-06-01 00:00:00

  • Diced cartilage grafts in rhinoplasty surgery.

    abstract::The use of diced cartilage grafts in rhinoplasty surgery was recently revived by Erol with the publication of his technique for "Turkish delight" grafts (i.e., diced cartilage grafts wrapped in Surgicel). The present study details the authors' experience with 50 consecutive diced cartilage grafts used in three configu...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000122544.87086.b9

    authors: Daniel RK,Calvert JW

    更新日期:2004-06-01 00:00:00

  • Neurotoxins: Expanding Uses of Neuromodulators in Medicine--Major Depressive Disorder.

    abstract:BACKGROUND:Botulinum toxin A (BTA) is one of the most diversely used medications of the 21st century and is now being researched as a treatment for major depressive disorder (MDD). METHODS:The authors performed a literature search of PubMed, Web of Science, and the Cochrane Register of Controlled Trials. The primary i...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0000000000001733

    authors: Magid M,Keeling BH,Reichenberg JS

    更新日期:2015-11-01 00:00:00

  • A Formidable Foe Is Sabotaging Your Results: What You Should Know about Biofilms and Wound Healing.

    abstract:LEARNING OBJECTIVES:After reading this article, the participant should be able to: 1. Describe biofilm pathogenesis as it relates to problem wounds. 2. Understand the preclinical and clinical evidence implicating biofilm in problem wounds. 3. Explain the diagnostic and treatment challenges that biofilms create for prob...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000003325

    authors: Barker JC,Khansa I,Gordillo GM

    更新日期:2017-05-01 00:00:00

  • Biostereometrics and computergraphics for patients with craniofacial malformations: diagnosis and treatment planning.

    abstract::Utilizing the techniques of biostereometric photography and current state-of-the-art computergraphics, topographic contourgrams have been generated in a series of patients with complex craniofacial malformations. These contourgrams are considered useful in diagnosis and treatment planning and as an aid in postoperativ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198504000-00007

    authors: Sen Savara B,Miller SH,Demuth RJ,Kawamoto HK

    更新日期:1985-04-01 00:00:00

  • Effect of protein depletion on skin graft "take" in rats.

    abstract::Protein malnutrition, with reduction of serum albumin from a normal level of 3.3 gm/dl to a 6-week depleted value of 2.1 gm/dl, does not appear to adversely affect the "take" of rat full-thickness skin grafts. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198001000-00012

    authors: Falcone RE,Ruberg RL

    更新日期:1980-01-01 00:00:00

  • Fingernail deformities secondary to ganglions of the distal interphalangeal joint (mucous cysts).

    abstract::Twenty-six nail deformities secondary to ganglions of the distal interphalangeal joint were retrospectively reviewed to assess the important aspects of their management. The patients' ages ranged from 41 to 79 years. The long and index fingers were most commonly involved. A depression or groove was present in 23 of 26...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199104000-00017

    authors: Brown RE,Zook EG,Russell RC,Kucan JO,Smoot EC

    更新日期:1991-04-01 00:00:00

  • Therapeutic value of intravenous heparin in microvascular surgery: an experimental vascular thrombosis study.

    abstract::In an attempt to decrease a 10 to 15 percent vascular thrombosis rate leading to graft occlusion, low-dose human-grade heparin was studied to determine if carefully monitored intravenous therapy would increase 7-day patency in a known potent thrombosis model. In New Zealand white rabbits, the type of infusate administ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198809000-00016

    authors: Greenberg BM,Masem M,May JW Jr

    更新日期:1988-09-01 00:00:00