Maximizing Solid Organ and Face Transplant Procurement Team Coordination: The Posterior Tibial Artery Flap as an Ideal Sentinel Flap

Marissa A. Suchyta PhD , Brian Carlsen MD , Karim Bakri MBBS , Hatem Amer MD , Samir Mardini MD
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Abstract

Face transplantation became a reality with the first case performed in 2005. Facial tissue allograft procurement is technically complex and time-intensive. Brain-dead deceased donors are frequently, if not always, multiorgan donors. Every effort should be made during face allograft recovery to minimize any risk to the recovery of lifesaving solid organs. Some programs require the procurement of a myofascial vascularized skin graft to function as a sentinel flap allowing frequent monitoring for rejection without negatively impacting the esthetics of the face graft. Up till now, the flap used has been the radial forearm flap. Procuring the radial forearm flap places the procuring team in close proximity to the head and torso, where the face recovery and the solid organ recovery teams would require unhindered access. Here, we present the posterior tibial artery flap as an alternative flap that would provide benefits to the coordination of the multiple teams working to procure organs from a deceased donor.

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最大限度地发挥实体器官和面部移植采购团队的协调作用:胫骨后动脉皮瓣是一种理想的哨兵皮瓣
2005年,第一例面部移植成为现实。面部组织同种异体移植物的获取在技术上是复杂的和耗时的。脑死亡的已故捐赠者往往是多器官捐赠者,如果不是总是这样的话。在面部异体移植物恢复过程中,应尽一切努力将挽救生命的实体器官恢复的风险降至最低。一些项目需要采购肌筋膜血管化皮肤移植物,以发挥前哨皮瓣的作用,从而在不影响面部移植物美观的情况下频繁监测排斥反应。到目前为止,使用的皮瓣是前臂桡侧皮瓣。采购前臂桡侧皮瓣使采购团队靠近头部和躯干,面部恢复和实体器官恢复团队需要不受阻碍地进入头部和躯干。在这里,我们提出了胫骨后动脉皮瓣作为一种替代皮瓣,它将有利于多个团队的协调,从已故捐赠者那里获得器官。
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来源期刊
Mayo Clinic proceedings. Innovations, quality & outcomes
Mayo Clinic proceedings. Innovations, quality & outcomes Surgery, Critical Care and Intensive Care Medicine, Public Health and Health Policy
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