RESUMO
Conditions such as congenital anomalies, cancers, and trauma can all result in devastating deficits of bone in the craniofacial skeleton. This can lead to significant alteration in function and appearance that may have significant implications for patients. In addition, large bone defects in this area can pose serious clinical dilemmas, which prove difficult to remedy, even with current gold standard surgical treatments. The craniofacial skeleton is complex and serves important functional demands. The necessity to develop new approaches for craniofacial reconstruction arises from the fact that traditional therapeutic modalities, such as autologous bone grafting, present myriad limitations and carry with them the potential for significant complications. While the optimal bone construct for tissue regeneration remains to be elucidated, much progress has been made in the past decade. Advances in tissue engineering have led to innovative scaffold design, complemented by progress in the understanding of stem cell-based therapy and growth factor enhancement of the healing cascade. This review focuses on the role of biomaterials for craniofacial bone engineering, highlighting key advances in scaffold design and development.
Assuntos
Materiais Biocompatíveis/uso terapêutico , Procedimentos de Cirurgia Plástica/métodos , Crânio/cirurgia , Engenharia Tecidual/métodos , Alicerces Teciduais , Ossos Faciais/cirurgia , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Desenho de Prótese , Transplante de Células-Tronco/métodosRESUMO
Large, full-thickness calvarial defects present a series of significant reconstructive challenges involving a range of techniques, including local and free flaps. Occasionally these conventional methods may not be possible due to technical, or patient, factors. Artificial dermis is already widely used in burns surgery and is increasing in oncological reconstruction. We believe that artificial dermis coupled with split-thickness skin grafting provides an excellent option for closure of these defects when other techniques are not appropriate.
RESUMO
Large, full-thickness calvarial defects present a series of significant reconstructive challenges involving a range of techniques, including local and free flaps. Occasionally these conventional methods may not be possible due to technical, or patient, factors. Artificial dermis is already widely used in burns surgery and is increasing in oncological reconstruction. We believe that artificial dermis coupled with split-thickness skin grafting provides an excellent option for closure of these defects when other techniques are not appropriate.
Assuntos
Carcinoma Basocelular/cirurgia , Sulfatos de Condroitina/uso terapêutico , Colágeno/uso terapêutico , Neoplasias de Cabeça e Pescoço/cirurgia , Couro Cabeludo , Neoplasias Cutâneas/cirurgia , Transplante de Pele , Pele Artificial , Crânio/cirurgia , Idoso de 80 Anos ou mais , Feminino , Humanos , Recidiva Local de Neoplasia/cirurgia , Transplante de Pele/métodosRESUMO
We describe a technique modification of the 'many tailed' flaps for multiple digital defects in adjacent digits described in 1980. This is a versatile technique for providing cover to multiple palmar and dorsal defects of the digits, avoiding the need to syndactylize digits, and when it is not desirable or adequate to perform multiple local flaps to cover the losses. The technical modifications are use of donor closure to adjust the position of the flaps in opposition, sequential donor closure to accurately place subsequent flaps, and raising flaps from less to more lax donor skin to avoid drift of donor site position.