Total face, double jaw, and tongue transplantation: an evolutionary concept.

Autor: Dorafshar AH; Baltimore, Md. From the R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, University of Maryland School of Medicine., Bojovic B, Christy MR, Borsuk DE, Iliff NT, Brown EN, Shaffer CK, Kelley TN, Kukuruga DL, Barth RN, Bartlett ST, Rodriguez ED
Jazyk: angličtina
Zdroj: Plastic and reconstructive surgery [Plast Reconstr Surg] 2013 Feb; Vol. 131 (2), pp. 241-251.
DOI: 10.1097/PRS.0b013e3182789d38
Abstrakt: Background: The central face high-energy avulsive injury has been frequently encountered and predictably managed at the R Adams Cowley Shock Trauma Center. However, despite significant surgical advances and multiple surgical procedures, the ultimate outcome continues to reveal an inanimate, insensate, and suboptimal aesthetic result.
Methods: To effectively address this challenging deformity, a comprehensive multidisciplinary approach was devised. The strategy involved the foundation of a basic science laboratory, the cultivation of a supportive institutional clinical environment, the innovative application of technologies, cadaveric simulations, a real-time clinical rehearsal, and an informed and willing recipient who had the characteristic deformity.
Results: After institutional review board and organ procurement organization approval, a total face, double jaw, and tongue transplantation was performed on a 37-year-old man with a central face high-energy avulsive ballistic injury.
Conclusions: This facial transplant represents the most comprehensive transplant performed to date. Through a systematic approach and clinical adherence to fundamental principles of aesthetic surgery, craniofacial surgery, and microsurgery and the innovative application of technologies, restoration of human appearance and function for individuals with a devastating composite disfigurement is now a reality.
Clinical Question/level of Evidence: Therapeutic, V.
Databáze: MEDLINE
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