The "Eve" procedure: the transfer of vascularized seventh rib, fascia, cartilage, and serratus muscle to reconstruct difficult defects

Plastic and Reconstructive Surgery
P J Guelinckx, N K Sinsel

Abstract

Very few microvascular units entertain the possibility of simultaneous vascularized transfer of bone, cartilage, muscle, and gliding fascia. In exceptionally complex conditions with loss of an essential joint, adjacent bone and functional muscle, reconstruction of all these structures at once may be necessary. At the same time, gliding tissue is often required to cover tendons. Reconstruction in one sitting prevents formation of dense scar tissue due to multiple interventions. Additionally, less bone resorption is seen if vascularized bone is used. Therefore, a more undisturbed tissue composition at the end is guaranteed. Moreover, rapid rehabilitation of moving function is possible with improvement in the final result. Finally, morbidity is lowered by using a single donor site, and costs are minimalized. We present four unique cases in which the seventh rib including the costochondral junction with overlying serratus muscle, branches of the thoracicus longus nerve, and adjacent fascia have been transferred as a microvascular unit to reconstruct two severely damaged hands and two other complex injuries. In analogy with the Bible story of the creation of "the woman," it is called the "Eve" procedure. The vascularized rib was use...Continue Reading

References

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Citations

Jan 13, 2005·Surgical and Radiologic Anatomy : SRA·S Erdogmus, F Govsa
Oct 30, 1999·Journal of Shoulder and Elbow Surgery·M B Laursen, K V Døssing
Mar 15, 2014·The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association·Rohit K KhoslaH Peter Lorenz
Jan 13, 2000·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·G SchultesH Kärcher
May 13, 2005·Journal of Shoulder and Elbow Surgery·Bruno FuchsAllen T Bishop
Sep 20, 2001·Annals of Plastic Surgery·P FaureM R Colonna
Oct 18, 2001·Plastic and Reconstructive Surgery·D W Chang, M J Miller
Jul 2, 2003·Microsurgery·Alexandru V Georgescu, Ovidiu Ivan
Mar 21, 1998·Plastic and Reconstructive Surgery·F CasabonaR Quarto
Apr 29, 2011·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Katarzyna Sporniak-TutakRobert Kowalczyk
Jun 19, 2019·World Journal of Surgical Oncology·Yun LiuXin-Li Zhan
May 18, 2020·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Charlotte JalouxAndré Gay
Aug 9, 2003·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Larry L CunninghamJason Ford
Mar 18, 2008·Oral and Maxillofacial Surgery Clinics of North America·Louis G Mercuri

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