Intracranial microvascular free flaps

Steven Levine, Evan S. Garfein, Howard Weiner, Michael J. Yaremchuk, Pierre B. Saadeh, Geoffrey Gurtner, Jamie P. Levine, Stephen M. Warren

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)89-96
Number of pages8
JournalJournal of Reconstructive Microsurgery
Volume25
Issue number2
DOIs
StatePublished - Feb 2009
Externally publishedYes

Fingerprint

Free Tissue Flaps
Infection
Encephalomalacia
Salvage Therapy
Muscles
Rectus Abdominis
Omentum
Superficial Back Muscles
Wounds and Injuries
Debridement
Titanium
Reoperation
Immune System
Neoplasms
Seizures
Anti-Bacterial Agents
Recurrence
Antibodies

Keywords

  • Infection
  • Intracranial
  • Microvascular free flap
  • Reconstruction
  • Salvage

ASJC Scopus subject areas

  • Surgery

Cite this

Levine, S., Garfein, E. S., Weiner, H., Yaremchuk, M. J., Saadeh, P. B., Gurtner, G., ... Warren, S. M. (2009). Intracranial microvascular free flaps. Journal of Reconstructive Microsurgery, 25(2), 89-96. https://doi.org/10.1055/s-0028-1090609

Intracranial microvascular free flaps. / Levine, Steven; Garfein, Evan S.; Weiner, Howard; Yaremchuk, Michael J.; Saadeh, Pierre B.; Gurtner, Geoffrey; Levine, Jamie P.; Warren, Stephen M.

In: Journal of Reconstructive Microsurgery, Vol. 25, No. 2, 02.2009, p. 89-96.

Research output: Contribution to journalArticle

Levine, S, Garfein, ES, Weiner, H, Yaremchuk, MJ, Saadeh, PB, Gurtner, G, Levine, JP & Warren, SM 2009, 'Intracranial microvascular free flaps', Journal of Reconstructive Microsurgery, vol. 25, no. 2, pp. 89-96. https://doi.org/10.1055/s-0028-1090609
Levine S, Garfein ES, Weiner H, Yaremchuk MJ, Saadeh PB, Gurtner G et al. Intracranial microvascular free flaps. Journal of Reconstructive Microsurgery. 2009 Feb;25(2):89-96. https://doi.org/10.1055/s-0028-1090609
Levine, Steven ; Garfein, Evan S. ; Weiner, Howard ; Yaremchuk, Michael J. ; Saadeh, Pierre B. ; Gurtner, Geoffrey ; Levine, Jamie P. ; Warren, Stephen M. / Intracranial microvascular free flaps. In: Journal of Reconstructive Microsurgery. 2009 ; Vol. 25, No. 2. pp. 89-96.
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