Document Detail


Intracranial microvascular free flaps.
MedLine Citation:
PMID:  18925548     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Large acquired intracranial defects can result from trauma or surgery. When reoperation is required because of infection or tumor recurrence, management of the intracranial dead space can be challenging. By providing well-vascularized bulky tissue, intracranial microvascular free flaps offer potential solutions to these life-threatening complications. A multi-institutional retrospective chart and radiographic review was performed of all patients who underwent microvascular free-flap surgery for salvage treatment of postoperative intracranial infections between 1998 and 2006. A total of six patients were identified with large intracranial defects and postoperative intracranial infections. Four patients had parenchymal resections for tumor or seizure and two patients had posttraumatic encephalomalacia. All patients underwent operative debridement and intracranial free-flap reconstruction using the latissimus dorsi muscle (N=2), rectus abdominis muscle (N=2), or omentum (N=2). All patients had titanium (N=4) or Medpor (N=2) cranioplasties. We concluded that surgery or trauma can result in significant intracranial dead space. Treatment of postoperative intracranial infection can be challenging. Vascularized free tissue transfer not only fills the void, but also provides a delivery system for immune cells, antibodies, and systemically administered antibiotics. The early use of this technique when intracranial dead space and infection coexist is beneficial.
Authors:
Steven Levine; Evan S Garfein; Howard Weiner; Michael J Yaremchuk; Pierre B Saadeh; Geoffrey Gurtner; Jamie P Levine; Stephen M Warren
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2008-10-16
Journal Detail:
Title:  Journal of reconstructive microsurgery     Volume:  25     ISSN:  0743-684X     ISO Abbreviation:  J Reconstr Microsurg     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-06     Completed Date:  2009-04-16     Revised Date:  2011-02-16    
Medline Journal Info:
Nlm Unique ID:  8502670     Medline TA:  J Reconstr Microsurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  89-95     Citation Subset:  IM    
Affiliation:
The Institute of Reconstructive Plastic Surgery, Department of Neurosurgery, New York University School of Medicine, New York, New York 10016, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Child
Combined Modality Therapy
Debridement
Head and Neck Neoplasms / surgery*
Humans
Infection / drug therapy,  surgery*
Male
Middle Aged
Postoperative Complications / surgery*
Reconstructive Surgical Procedures / methods*
Retrospective Studies
Salvage Therapy
Skull / injuries,  surgery*
Surgical Flaps / blood supply*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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