Combined anterior thigh flaps and vascularised fibular graft for reconstruction of massive composite oromandibular defects

M, Ao; Asagoe, Kenji; Maeta, Manabu; Nakagawa, Fumio; Saito, Ryusuke; Nagase, Yoh

doi:10.1054/bjps.1997.0173

Cited by 37 publications

(29 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The most challenging reconstructions are of composite and extensive composite oromandibular defects resulting from excision of T3 and T4 cancers. [1][2][3][4][5] Revolutionary microvascular surgical techniques permit surgeons to use vascularized bone and overlying soft tissue for reconstruction of compound or composite mandibular defects. 6 Although a single osteocutaneous flap is adequate for most of these defects, the best results for extensive composite mandibular defects can be obtained by using two free flaps in one stage, one for the bone and inner lining and one for the skin and soft tissue.…”

mentioning

confidence: 99%

Complications after Reconstruction by Plate and Soft-Tissue Free Flap in Composite Mandibular Defects and Secondary Salvage Reconstruction with Osteocutaneous Flap

Wei

Çelik

Yang

et al. 2003

Plastic and Reconstructive Surgery

188

115

View full text Add to dashboard Cite

Reconstruction of composite defects of the mandible is a challenging problem. Although the use of an osteocutaneous free flap, alone or in combination with another soft-tissue free flap, is generally accepted to be optimal, the bony reconstruction is sometimes undervalued, especially when the cancer is advanced. In such situations, reconstruction is often performed with a reconstruction plate covered with a soft-tissue free flap. Between January of 1997 and July of 2000, 80 patients with composite or extensive composite oromandibular defects underwent treatment with a reconstruction plate and a soft-tissue free flap. All of the patients were male, and the ages of the patients at the time of treatment ranged from 32 to 78 years (mean, 51 years). Tumors were classified as stage IV in 56 patients (70 percent), whereas the remaining 24 patients (30 percent) had recurrent carcinomas. The titanium mandibular reconstruction system manufactured by Stryker (Freiburg, Germany) was used to bridge the mandibular defects. The soft-tissue free flaps used for wound and plate coverage were as follows: anterolateral thigh flap (n = 75), radial forearm flap (n = 3), transverse rectus abdominis myocutaneous flap (n = 1), and tensor fasciae latae flap (n = 1). Five patients with recurrent carcinomas and 10 with stage IV carcinomas (18.75 percent) died 2 to 6 months after the operation and were excluded from the study. The remaining 65 patients were monitored for an average follow-up period of 22 months (range, 6 to 40 months). During that period, one or more complications occurred for 45 patients (69.2 percent). Plate exposure was the most common complication and was observed for 30 patients (46.15 percent). Twenty of the 65 patients (30.8 percent) required secondary salvage reconstruction with a fibula osteoseptocutaneous flap. The decision to perform a secondary salvage procedure was based on the general health of the patient, the extent of local disease, and the severity of the complications. Patients underwent salvage operations after an average of 11.5 months (range, 6 to 26 months). The major reasons for the second operation were as follows: reconstruction plate exposure (n = 12), soft-tissue deficiency and mandibular contour deformation of the lateral face (n = 7), intraoral contracture and lack of a gingivobuccal sulcus (n = 6), trismus (n = 4), and osteoradionecrosis of the mandible (n = 2). The total flap survival rate was 90 percent (18 of 20 free flaps). In two cases, the skin paddles of the fibula osteoseptocutaneous flaps exhibited partial failure and were revised with pedicled pectoralis major and deltopectoral flaps. The reconstruction plate and free soft-tissue flap procedure for the reconstruction of composite defects of the oromandibular region has many late complications, which eventually necessitate reconstruction of the mandible with an osteocutaneous free flap.

show abstract

mentioning

confidence: 99%

Complications after Reconstruction by Plate and Soft-Tissue Free Flap in Composite Mandibular Defects and Secondary Salvage Reconstruction with Osteocutaneous Flap

Wei

Çelik

Yang

et al. 2003

Plastic and Reconstructive Surgery

188

115

View full text Add to dashboard Cite

show abstract

“…The AMT flaps based on the descending branch of the lateral circumflex femoral vessels provided a long vascular pedicle and a large flap without sacrificing principal vessels and muscles for reconstruction of head and neck region defects following tumour ablation and oromandibular defects [2]. Although, many studies in literature described the advantages of using AMT flaps, there were some studies which reported the disadvantages of these flaps due to possible variations of the LCFA [1,2]. Notably, several authors controversially discussed vasculature of the thigh region [23].…”

Section: Discussionmentioning

confidence: 99%

“…Anteromedial fasciocutaneous flaps from the thigh region based on the lateral circumflex femoral artery (LCFA) are important for repairing the defects of wide inguinal scars, the soft tissue defects following foot injury, after benign or extensive malignant tumour ablation of head and neck region, lower abdomen, leg, major scrotal defects, post-burn contractures in the body [1,10,12,19,31].…”

Section: Introductionmentioning

confidence: 99%

Anatomy of the anteromedial thigh flap based on the oblique branch of the descending branch of the lateral circumflex femoral artery

Tayfur

Mağden²,

Edizer³

et al. 2016

Folia Morphol

View full text Add to dashboard Cite

show abstract

“…Se han asociado la cresta ilíaca con el colgajo radial; 5,12 el colgajo osteocutáneo de escápula con el radial; 6,12 el peroné con el radial o el lateral del brazo; 1,2,13,14 y el peroné con anterolateral de muslo. 9,10,15 También, hay descritas asociaciones de dos colgajos libres para reconstrucción de partes blandas: radial bilateral para cavidad oral; 2 para esó-fago; 16 para defectos de tercio medio tras heridas por arma de fuego 17 y dos colgajos de TRAM para restaurar el contorno facial. 18 Asimismo, hay publicaciones de tres colgajos libres microvascularizados simultáneos: peroné con dos radiales, 14 e incluso de cinco colgajos libres microvascularizados: radial bilateral, gracilis bilateral inervado y miocutáneo de recto abdominal.…”

Section: Discussionunclassified

“…Cada vez existen más aportaciones en la bibliografía donde se utilizan dos colgajos para solucionar el problema de las reconstrucciones oromandibulares complejas. 1,2,[5][6][7][8][9][10][11] La combinación de varios colgajos pretende suplir los defectos que puede tener una reconstrucción única en defectos complejos. Cada colgajo se selecciona independientemente por sus características que lo hacen ideal para cada tipo de defecto, óseo y de partes blandas con la finalidad de conseguir un resultado estético y funcional superior a la utilización de un solo colgajo.…”

Section: Introductionunclassified

Reconstrucción compleja de la cavidad oral mediante dos colgajos simultáneos de peroné y radial

Ferrer¹,

Granados²,

Camacho³

et al. 2004

Rev Esp Cirug Oral y Maxilofac

View full text Add to dashboard Cite

Resumen: El objetivo del presente trabajo es valorar los resultados funcionales y estéticos de reconstrucciones complejas orofaciales, realizadas mediante la asociación de dos colgajos libres simultáneos de peroné y radial. Se ha realizado este tipo de reconstrucción en tres pacientes con buenos resultados funcionales y estéticos. La reconstrucción con dos colgajos libres está indicada en defectos complejos en los que la reconstrucción con un solo colgajo no obtendría resultados estéticos y funcionales adecuados. Cada colgajo se selecciona por sus características que lo hacen ideal para cada tipo de defecto, óseo y de partes blandas con la finalidad de conseguir un resultado estético y funcional superior al que se obtendría con un solo colgajo.Palabras clave: Colgajos libres; Defectos oromandibulares complejos; Reconstrucción oromandibular; Colgajo libre de peroné; Colgajo libre radial; Colgajos libres simultáneos. Abstract: The aim of this paper is to evaluate the functional and aesthetic results of complex orofacial reconstructions by means of the combination of two simultaneous free flaps (fibula osteocutaneous and radial forearm flaps). Three patients who have undergone this kind of reconstruction are presented with good functional and aesthetics results. Reconstruction with two free flaps is indicated in complex defects

show abstract

Combined anterior thigh flaps and vascularised fibular graft for reconstruction of massive composite oromandibular defects

Cited by 37 publications

References 14 publications

Complications after Reconstruction by Plate and Soft-Tissue Free Flap in Composite Mandibular Defects and Secondary Salvage Reconstruction with Osteocutaneous Flap

Complications after Reconstruction by Plate and Soft-Tissue Free Flap in Composite Mandibular Defects and Secondary Salvage Reconstruction with Osteocutaneous Flap

Anatomy of the anteromedial thigh flap based on the oblique branch of the descending branch of the lateral circumflex femoral artery

Reconstrucción compleja de la cavidad oral mediante dos colgajos simultáneos de peroné y radial

Contact Info

Product

Resources

About