Microvascular network of the healing surface over the temporalis flap in maxillary reconstruction

Abstract

This study aims to describe and quantify the microvascular changes of the healing wound in a maxilla reconstructed by a temporalis myofascial flap (TMF). 24 cats underwent partial maxillectomies and reconstruction by TMF. Vascular infusion was performed immediately following sacrifice and then analyzed by radiography, light and SEM. Results showed that the superficial microvascular layer overlying the TMF underwent a similar transformation as in the histological healing sequence. The vascular density was highest during the initial 6 weeks, followed by reducing density at the chronic inflammatory phase, to normal at the proliferative and remodelling phases. The migrating epithelium brought on a microvascular sub-epithelial plexus, which eventually covered the TMF. The finding that the vascular source of this sub-epithelial plexus comes from the surrounding tissues rather than from the underlying TMF will have surgical implications for bony reconstruction of the maxilla.