Secondary bone reconstruction

Abstract

Secondary reconstruction of craniofacial skeletal defects represents a particularly challenging subset of maxillofacial surgery. Whether planned as part of multistage procedures or to address complications from primary reconstructive procedures that result in full-thickness bone defects or other suboptimal outcomes, secondary cases of maxillofacial reconstruction are typically more complicated than the initial reconstructive procedure. These surgeries are often associated with hostile wound environments that may be characterized by hypoxia, poorly compliant soft tissue envelopes (e.g., restrictive scar tissue burden), and, in certain cases, radiation injury. Not uncommonly, complex defects of the craniofacial skeleton require recruitment of soft tissue as well as bone to reestablish stable form and function.