Faculty Collaboration Database

Revascularization of free mandibular reconstruction after early emergency arterial ligation. Ann Plast Surg 1994 Nov;33(5):552-6

Date

11/01/1994

Pubmed ID

7857052

DOI

10.1097/00000637-199411000-00015

Scopus ID

2-s2.0-0028062728 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

A 70-year-old man with a squamous cell carcinoma involving the anterior arch and body of the mandible underwent resection and reconstruction with a 10-cm free vascularized iliac crest bone graft, preserving periosteum and minimal adjacent soft tissue. On postoperative day 12, he experienced bleeding from an orocutaneous fistula, requiring emergency ligation of the arterial pedicle to control hemorrhage. After ligation, continued bleeding was noted from the margin of the graft, with active filling of the venous pedicle. The 10-cm mandibular bone graft survived without appreciable resorption during a period of follow-up of 5 years. We believe that bone graft survival in the present case was due to early vascular communication between the periosteum and adjacent soft tissues of the graft with the recipient bed. This mechanism may serve to maintain bone graft viability after early arterial disruption, when repeat arterial anastomosis is believed to be contraindicated.

Author List

Bonawitz S, Gosain AK, Matloub HS, Larson DL

Author

Hani S. Matloub MD Professor in the Plastic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Anastomosis, Surgical
Arteries
Bone Transplantation
Carcinoma, Squamous Cell
Emergencies
Humans
Ligation
Male
Mandible
Mandibular Neoplasms
Mouth Neoplasms
Surgery, Plastic