Reconstructive Surgery of the Head and Neck in Organ Transplant Recipients: A Case Report and a Review of the Literature

被引:0
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作者
Rampi, Andrea [1 ]
Comini, Lara Valentina [2 ]
Galli, Andrea [3 ,4 ]
Howardson, Bright Oworae [3 ,4 ]
Tettamanti, Alberto [3 ,4 ]
Luparello, Paolo [2 ]
Redaelli, Gabriele [1 ]
Di Santo, Davide [2 ]
Bondi, Stefano [2 ]
机构
[1] Sondrio Hosp, Otorhinolaryngol Unit, ASST Valtellina & Alto Lario, I-23100 Sondrio, Italy
[2] FPO IRCCS, Candiolo Canc Inst, Otorhinolaryngol Head & Neck Surg, I-10060 Turin, Italy
[3] IRCCS San Raffaele Sci Inst, Div Head & Neck Dept, Otorhinolaryngol Unit, I-20132 Milan, Italy
[4] Univ Vita Salute San Raffaele, Sch Med, I-20132 Milan, Italy
关键词
head and neck surgery; solid organ recipients; wound healing; immunosuppressive agents; reconstructive flaps; WOUND-HEALING COMPLICATIONS; KIDNEY-TRANSPLANTATION; LIVER-TRANSPLANTATION; CANCER INCIDENCE; RISK; IMMUNOSUPPRESSION; TACROLIMUS; COHORT;
D O I
10.3390/jcm13164790
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The number of solid organ transplant recipients (SOTRs) is growing as a consequence of an increase in transplantations and longer survival; these patients, thus, frequently suffer various comorbidities and are subjected to the detrimental effects of immunosuppressive agents, which expose them to a higher risk of developing malignancies. These drugs also complicate the surgical treatment of neoplasms, as they can hinder wound healing, especially when associated with other unfavorable factors (e.g., previous radiotherapy, diabetes, etc.). We herein present our experience with a 74-year-old SOTR who underwent a radical extended parotidectomy and reconstruction with a submental island flap for a persistent cutaneous squamous carcinoma after radiotherapy; his complicated clinical course was characterized by incredibly slow wound healing. The current literature was reviewed to provide a succinct overview of the main difficulties of head and neck surgery in SOTRs. In particular, the immunosuppressive regimen can be tapered considering the individual risk and other elements should be carefully assessed, possibly prior to surgery, to prevent cumulative harm. New developments, including intraoperative monitoring of flap vascularization through indocyanine green fluorescence video-angiography and the prophylactic application of negative pressure wound therapy, when feasible, may be particularly beneficial for high-risk patients.
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页数:11
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