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The Military Relevance of Face Composite Tissue Allotransplantation and Regenerative Medicine Research

  • Robert G. Hale
Chapter

Abstract

Maxillofacial battle injuries created the need for plastic and maxillofacial reconstructive surgery during World War I (WWI). Devastating maxillofacial injuries challenged the surgical professions to provide form and function to the defects inflicted by penetrating trauma on the battlefield. Local, regional, and distant flap transfers were developed to treat maxillofacial battle injuries in WWI and while still valued procedures, multiple surgical steps, donor site morbidity and limited esthetic-functional outcomes are often the result. During the 1980s, the advent of microsurgery added an invaluable tool to the reconstructive surgeons’ armamentarium. However, despite significant technical advances, the results following major traumatic war injuries are less than satisfactory, both esthetically and functionally. Facial allotransplantation may offer an invaluable alternative to traditional reconstructive options.

Keywords

Service Member Negative Pressure Wound Therapy Facial Defect Maxillofacial Injury Composite Tissue 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

CMV

Cytomegalovirus

ENT

Ear, Nose, and Throat

IMF

Inter-maxillary Fixation

ISR

Institute of Surgical Research

NPWT

Negative pressure wound therapy

OMS

Oral and Maxillofacial Surgeons

WWI

World War I

Notes

Disclaimer

The opinions or assertions contained herein are the private view of the author and should not be construed as official or reflecting the views of the Department of Defense or the US Government; the author is an employee of the US Government.

All photographs courtesy of COL Robert G Hale.

References

  1. 1.
    Beebe GW, DeBakey ME. Location of hits and wounds. In: Battle Casualties. Springfield: Charles C. Thomas; 1952:165-205.Google Scholar
  2. 2.
    Santoni-Ruigi P, Sykes PJ. History of Plastic Surgery. Heidelberg: Springer; 2007.Google Scholar
  3. 3.
    Vasilic D, Barker J, Blagg R, Whitaker I, Kon M, Gossman MD. Facial transplantation: an Anatomic and Surgical Analysis of the Periorbital Functional Unit. Plast Reconstr Surg. 2010;125(1):125-134.PubMedCrossRefGoogle Scholar
  4. 4.
    Sikes JW, Ghali GE. Lip cancer. In: Miloro M, ed. Peterson’s Principles of Oral and Maxillofacial Surgery. Vol. 1. Chapter 34. Hamilton, Ontario, Canada: BC Decker; 2004.Google Scholar
  5. 5.
    Lew TA, Walker JA, Wenke JC, Blackbourne LH, Hale RG. Characterization of maxillofacial battle injuries in U.S. service members in Operation Iraqi Freedom and Operation Enduring Freedom. J Oral Maxillofac Surg. 2010;68:3-7.PubMedCrossRefGoogle Scholar
  6. 6.
    Owens BD, Kragh JF, Wenke JC, et al. Combat wounds in Operation Iraqi Freedom and Operation Enduring Freedom. J Trauma. 2008;64:295-299.PubMedCrossRefGoogle Scholar
  7. 7.
    Kauvar DS, Wolf SE, Wade CE, et al. Burns sustained in combat explosions in Operation Iraqi and Enduring Freedom (OIF/OEF explosion burns). Burns. 2006;32:853-857.PubMedCrossRefGoogle Scholar
  8. 8.
    Powers DB, Will MW, Bourgeois SL, et al. Maxillofacial treatment protocol. J Oral Maxillfac Surg Clin North Am. 2005;17:341-355.CrossRefGoogle Scholar
  9. 9.
    Futran N. Maxillofacial trauma reconstruction. Facial Plat Surg Cin North Am. 2009;17:239-251.CrossRefGoogle Scholar
  10. 10.
    Peleg K, Aharonson-Daniel L, Stein M, et al. Gunshot and explosion injuries: characteristics, outcomes, and implications for care of terror-related injuries in Israel. Ann Surg. 2004;239:311-318.PubMedCrossRefGoogle Scholar
  11. 11.
    Dubernard JM, Lengele B, Morelon E, et al. Outcomes 18 months after the first human partial face transplantation. N Engl J Med. 2007;357:2451-2460.PubMedCrossRefGoogle Scholar
  12. 12.
    Shuker ST. Maxillofacial blast injuries. J Craniomaxillofac Surg. 1995;23:91-98.PubMedGoogle Scholar
  13. 13.
    Siemionow M, Klimczak A. Basics of immune responses in transplantation in preparation for application of composite tissue allografts in plastic and reconstructive surgery: part I. Plast Reconstr Surg. 2008;121:4e-12e.PubMedCrossRefGoogle Scholar
  14. 14.
    Jones NF, Johnson JT, Shestak KC, et al. Microsurgical reconstruction of the head and neck: interdisciplinary collaboration between head and neck surgeons and plastic surgeons in 305 cases. Ann Plast Surg. 1996;36:36-43.Google Scholar
  15. 15.
    Rumsey N. Psychological aspects of face transplantation: read the small print carefully. Am J Bioeth. 2004;4:22.PubMedGoogle Scholar
  16. 16.
    Morris PJ, Monaco AP. Facial transplantation, is the time right? Transplantation. 2004;77:329.CrossRefGoogle Scholar

Copyright information

© Springer London 2011

Authors and Affiliations

  1. 1.Craniomaxillofacial ResearchU.S. Army Institute of Surgical ResearchSan AntonioUSA

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