Double-Paddle Peroneal Tissue Transfer for Oromandibular Reconstruction

Abstract

The double-paddle peroneal tissue transfer is a useful technique for reconstructing the extensive and complex defect that results after ablative surgery for oral cancer. It can facilitate the design and inset of the skin paddle and avoid the need for a second free flap. The two skin paddles can be based on either two cutaneous perforators of the peroneal vessels or two branches of a single cutaneous perforator. The authors report their experience with double-paddle peroneal tissue flaps (10 fasciocutaneous and five osteocutaneous) in 15 patients. The largest double paddle used was (16 x 9) (15 x 6) cm, and the smallest one was (7 x 5.5) (4.5 x 4) cm. All flaps were used for both intraoral and extraoral defect reconstruction. There was one single skin paddle necrosis caused by erroneous manipulation of the flap 1 week after the operation; however, the skin paddle had survived completely before the manipulation. All other flaps survived completely, with a good to excellent appearance, and no patient had a significant gait disturbance after the operation.

A treatment algorithm for managing giant mandibular ameloblastoma: 5-year experiences in a Paris university hospital

“…18 In this respect, a skin paddle of the septocutaneous FFF should be located in the middle and distal thirds of the leg, and may be divided based on the separate perforating vessels. 27 When the paddle size is excessive, it can be de-epithelialised with the preservation of the perforators to maintain the vasculature.…”

The Use of Double Independent Free Flaps for Tissue Reconstruction After Extensive Head and Neck Tumors Resection

“…In such cases FFF or RFFF double or triple flaps are used. The above-mentioned are used in case of the following: reconstruction of intraoral defects including the lower face skin, or multiple extraoral defects (1,9). Based on the Authors' experience, such flaps prove efficient.…”

Double-skin paddle perforator flap from the lateral lower leg for reconstruction of through-and-through cheek defect – a report of two cases

“…Therefore, flaps from the lateral lower leg with their primarily thin and pliable skin were also considered to be used for intraoral reconstruction 18,20 .…”

“…Free perforator flaps from the lateral lower leg offer a large skin paddle supported by a single perforator vessel up to 20 cm  13 cm 10,20 . This can facilitate the design and inset of the skin paddles and avoid the need of a second free flap.…”