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Microvascular replantation of head and neck amputated parts: A systematic review.

Microvascular replantation of head and neck amputated parts: A systematic review.
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Efanov JI, Montoya IJ, Huang KN, Guertin C, Harris PG, Bou-Merhi J, Danino AM,


Efanov JI, Montoya IJ, Huang KN, Guertin C, Harris PG, Bou-Merhi J, Danino AM, (click to view)

Efanov JI, Montoya IJ, Huang KN, Guertin C, Harris PG, Bou-Merhi J, Danino AM,

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Microsurgery 2017 04 22() doi 10.1002/micr.30182
Abstract
BACKGROUND
As opposed to upper and lower extremity amputations representing a considerable volume of admissions, the prowess of microsurgeons is seldom solicited in complex cases of head and neck replantation. Our aim was to determine the rate of successful replantation of craniofacial parts in a systematic review of the literature.

METHODS
We performed a systematic review of English literature using PubMed/MEDLINE for every replantation of a head and neck parts. Articles selected for analysis required to describe microvascular surgical techniques to be considered a replantation. The measured endpoint for a successful replantation was survival at hospital discharge.

RESULTS
From 113 articles from the literature, reported cases of replanted craniofacial parts included 90 scalps, 56 ears, 34 lips, 26 noses, 1 eyebrow, and 1 midface. A significant majority of amputations were described as an avulsion mechanism (78.4%), as opposed to cutting/sharp (17.3%) or crush-type (1.9%). The overall success rate at hospital discharge was 72.1%, with a partial failure at 20.2% and a complete failure at 7.7%.

CONCLUSION
Urgent replantation of head and neck amputated parts allow patients to recover in a timely manner and to decrease the need for secondary reconstructive procedures. The significant rate of success is a strong argument in favor of promoting access to care for replantation of craniofacial parts.

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