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Microsurgical composite tissue transplantation.

Publication ,  Journal Article
Serafin, D; Georgiade, NG
Published in: Ann Surg
June 1978

Since 1974, 69 patients with extensive defects have undergone reconstruction by microsurgical composite tissue transplantation. Using this method, donor composite tissue is isolated on its blood supply, removed to a distant recipient site, and the continuity of blood flow re-established by microvascular anastomoses. In this series, 56 patients (81%) were completely successful. There have been eight (12%) failures, primarily in the extremities. There have been five (7%) partial successes, (i.e., a microvascular flap in which a portion was lost requiring a secondary procedure such as a split thickness graft). In those patients with a severely injured lower extremity, the failure rate was the greatest. Most of these were arterial (six of seven). These failures occurred early in the series and were thought to be related to a severely damaged recipient vasculature. This problem has been circumvented by an autogenous interpositional vein graft, permitting more mobility of flap placement. In the upper extremity, all but one case were successful. Early motion was permitted, preventing joint capsular contractures and loss of function. Twenty-three cases in the head and neck region were successful (one partial success). This included two composite rib grafts to the mandible. Prolonged delays in reconstruction following extirpation of a malignancy were avoided. A rapid return to society following complete reconstruction was ensured. Nine patients presented for reconstruction of the breast and thorax following radical mastectomy. All were successfully reconstructed with this new technique except one patient. Its many advantages include immediate reconstruction without delayed procedures and no secondary deformity of the donor site. Healthy, well vascularized tissue can now be transferred to a previously irradiated area with no tissue loss. This new method offers many advantages to older methods of reconstruction. Length of hospital stay and immobilization are reduced. The total number of operative procedures required in achieving the desired result is also less, thus decreasing the cost of hospital care.

Duke Scholars

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

June 1978

Volume

187

Issue

6

Start / End Page

620 / 628

Location

United States

Related Subject Headings

  • Transplantation, Autologous
  • Thorax
  • Thoracic Surgery
  • Surgery, Plastic
  • Surgery
  • Neck
  • Microsurgery
  • Male
  • Leg
  • Humans
 

Citation

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Serafin, D., & Georgiade, N. G. (1978). Microsurgical composite tissue transplantation. Ann Surg, 187(6), 620–628. https://doi.org/10.1097/00000658-197806000-00006
Serafin, D., and N. G. Georgiade. “Microsurgical composite tissue transplantation.Ann Surg 187, no. 6 (June 1978): 620–28. https://doi.org/10.1097/00000658-197806000-00006.
Serafin D, Georgiade NG. Microsurgical composite tissue transplantation. Ann Surg. 1978 Jun;187(6):620–8.
Serafin, D., and N. G. Georgiade. “Microsurgical composite tissue transplantation.Ann Surg, vol. 187, no. 6, June 1978, pp. 620–28. Pubmed, doi:10.1097/00000658-197806000-00006.
Serafin D, Georgiade NG. Microsurgical composite tissue transplantation. Ann Surg. 1978 Jun;187(6):620–628.

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

June 1978

Volume

187

Issue

6

Start / End Page

620 / 628

Location

United States

Related Subject Headings

  • Transplantation, Autologous
  • Thorax
  • Thoracic Surgery
  • Surgery, Plastic
  • Surgery
  • Neck
  • Microsurgery
  • Male
  • Leg
  • Humans