上颌骨重建转移瓣.pptVIP

1 MAXILLOFACIAL RECONSTRUCTION 2 Basic Introduction about Maxillofacial Reconstruction Classification System for Maxillectomy and Midfacial Defects (1) 3 Type 1 defects (limited maxillectomy): one or two walls of the maxilla Type 2 defects (subtotal maxillectomy) the lower five walls with preservation of the orbital floor Type 3 defects (total maxillectomy) all six walls of the maxilla type 3a (orbital content preservation) type 3b (orbitalcontent exenteration) Type 4 defects (orbitomaxillectomy) the orbital contents and upper five walls of the maxilla, with preservation of the palate 4 Modified Maxillectomy Classification Scheme (2) 5 Algorithm to Depict Tissue Options for Midface Reconstruction (3) 6 Split thickness skin grafts Local flaps Palatal mucoperiosteal island flap Buccal fat pad Regional flaps Deltopectoral Temporalis Submental Free-bone grafts and free-tissue transfer Osteocutaneous Fasciocutaneous Myocutaneous ‘Sandwich’ wraps Reconstructive Options 7 Split Thickness Skin Grafts Local Flaps Regional Flaps Split-Thickness Skin Graft (STSG) 8 /burns/grafts.html Surgical Technique 9 Different thickness : (0.005-0.012 in), intermediate (0.012-0.018 in), or thick (0.018-0.030 in), Postoperative Suggestions 10 Select different dressing light to moderate exudate : polyurethane films; moderate : hydrocolloids heavily : calcium alginates Pressure bandaging for at least 24–48 hours Persistent clinical signs of infection: A short course of topical antimicrobials Maintain until be removedable without trauma Leakage without infection need reinforce dressing Wash donors sites gently and have A moisturiser applied at least twice daily Avoid UV exposure to the donor site 11 Local Flaps Palatal mucoperiosteal island flap Buccal fat pad Regional Flaps Split Thickness Skin Grafts Palatal mucoperiostealIsland Flap 12 Anastomosis of the greater palatine artery and the naso-palatine branch of the sphenopalatine artery Mucoperiosteum secured to