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SKELETAL TISSUE ENGINEERING: MICROSURGICAL RECONSTRUCTIVE PROCEDURES



Abstract

Composite tissue defects in absence of general contra-indications are now routinely dealt by composite free tissue transfers which now stand as routine procedures. When dealing with amputations of the thumb several reconstructive procedures are now available and should be tailored on individual basis.

Microvascular surgical techniques are especially gratifying when the appropriate indications are followed: young age, absence of systemic diseases no alcohol or smoke abuse.

A custom – made thumb can be reconstructed assembling in a single composite tissue graft different tissues harvested from various parts of the body.

An outcome study as been performed on 72 patients where the wrap-around technique, the second and great toe transfer have been carried out.

Overall assessment included, as a preliminary analysis, the of vassessement behaviour of each single transferred tissue: the nail complex, the pulp and the bone. Donor – site problems at the foot were assessed by gait analysis. Vascular complications were recorded in 5% of the patients, and 89% of the patients had excellent outcomes.

The abstracts were prepared by Ms Grazia Gliozzi. Correspondence should be addressed to her at the Italian Orthopaedic Research Society, Laboratory for Pathophysiology, Instituti Ortopedici Rizzoli, University of Bologna, Bologna, Italy.