Mechanics of First Near-Total Face Transplant Explained

Composite face allotransplantation completed in a single surgical procedure

WEDNESDAY, July 15 (HealthDay News) -- The procedure used for the composite face transplantation of an American citizen has been explained in a paper published online on July 15 in The Lancet.

Maria Siemionow, M.D., of the Cleveland Clinic, and colleagues describe how the patient, who sustained a gunshot wound to the face in 2004, which destroyed her nose, mouth, nerves and skin in the middle part of her face, was admitted on December 9, 2008 to undergo a tailored composite allograft of 80 percent of her face.

Within three hours of the connection of arteries and veins, the donor tissue started to pink up, at which point the facial nerves were connected, the scientists explain. The operation took 22 hours. The patient quickly accepted her new face and had no adverse reaction to either the graft or the immunosuppressive medication. Functional outcome at the six-month mark was excellent, the researchers report.

"Conventional reconstructive techniques should be the main option when the surgical goal is skin coverage," the authors write. "However, we have shown that in such extreme cases, face transplantation, although innovative, is a practicable alternative and should be taken into consideration as an early option, if only to spare a patient years of continued disfigurement, social ostracism, and the cumulative financial burden of multiple reconstructions."

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