Revascularized composite grafts with inserted implants for reconstructing the maxilla--improved flap design and flap prefabrication.
We present a new technique including prefabrication of a revascularized composite scapular flap that will fit a maxillary defect exactly. The method is based on careful preoperative planning using three-dimensional reconstructions of data obtained from computed tomograms and stereolithographic models. A pedicled scapular flap with a split skin graft envelope that has endosteal implants already inserted is prepared and covered by a polytetrafluoroethylene (PTFE, Goretex) membrane. After 3-4 months these prefabricated grafts are harvested, inserted into the maxillary defects, and reanastomosed to the facial vessels. Two to three weeks later, after mucosal healing, a prosthesis can be fitted on the endosteal implants. Histological evaluation of the flap shows vital bone reactions and attachment of the split skin graft.
Vinzenz
K G
KG
Department of Maxillofacial Surgery, Institute for Oral and Maxillofacial Surgery, University of Vienna, Austria.
Holle
J
J
Würinger
E
E
Kulenkampff
K J
KJ
Plenk
H
H
D001166:Arteriovenous Shunt, Surgical; D016025:Bone Transplantation / Q000379:methods* / Q000502:physiology; D003758:Dental Implantation, Endosseous; D005145:Face / Q000098:blood supply; D006085:Graft Survival; D006801:Humans; D007601:Jugular Veins; D008437:Maxilla / Q000601:surgery*; D008567:Membranes, Artificial; D008866:Microsurgery; D008953:Models, Anatomic; D010347:Patient Care Planning; D011138:Polytetrafluoroethylene; D012540:Scapula / Q000098:blood supply / Q000637:transplantation*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply*; D014057:Tomography, X-Ray Computed
D008567:Membranes, Artificial; D011138:Polytetrafluoroethylene