Analysis In Vivo of the Hemifacial Transplantation Surgical Technique.

Autor: Rodrigues IQ; Federal University of Paraná., Cunico C; Federal University of Paraná., Silva ABDD; Federal University of Paraná., Brum JS; Federal University of Paraná., Robes RR; Federal University of Paraná., Freitas RDS; Plastic Surgery Department, Federal University of Paraná, Curitiba, Brazil.
Jazyk: angličtina
Zdroj: The Journal of craniofacial surgery [J Craniofac Surg] 2019 May/Jun; Vol. 30 (3), pp. 944-946.
DOI: 10.1097/SCS.0000000000005377
Abstrakt: Approximately 35 facial transplants have been performed worldwide. Many under-explored aspects of this procedure remain, some emerging as the survivors age. Human-like preclinical trial models, including swine, can be explored and developed as a foundation for subsequent studies. A previously described surgical technique for face transplantation in swine carcasses has been employed herein, evaluating its reproducibility in a live pig and the viability of the vascular pedicles.
Method: Flap construction was performed according to the experimental model developed in our service. Under general anesthesia, the structures of the left hemiface of a pig were dissected. Vascular pedicles were the facial artery, caudal auricular artery, and external jugular vein. After dissection, adequate tissue perfusion of the entire explant by those pedicles was documented through vessel filling, observation of the ischemic area, and posterior reperfusion.
Results: A capillary reperfusion test confirmed that the main arterial pedicle irrigating the hemiface flap was the facial artery. The same technique showed that despite divergent literary opinions on the irrigation of the auricular region, the caudal auricular artery provides the arterial supply for the external ear. Performing the surgical technique was more difficult in vivo due to the inherent complications of a live subject.
Conclusion: The methodology for the facial transplant technique in swine carcasses was satisfactorily reproducible in a live animal. The main arterial pedicle responsible for flap irrigation is the facial artery, and the fact that the vessel supplying the outer ear is the caudal atrial artery was confirmed.
Databáze: MEDLINE