Experience With the Use of Free Fasciocutaneous Flap in Through-and-Through Cheek-Buccal Defect Reconstruction

Lin, Chih‐Hsun; Chiu, Yen-Hao; Perng, Cherng-Kang; Liao, Wen-Chieh; Ma, Hsu

doi:10.1097/sap.0000000000000692

Cited by 14 publications

(7 citation statements)

References 26 publications

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“…Among those, the RFFF was mainly harvested for cutaneous reconstruction (73.7%), the ALT flap for reconstruction of myocutaneous defects (83.3%), and the scapular/parascapular free flap for bone reconstruction (62.5%). Our flap survival rate was 95.7%, which is comparable to 95% to 96% reported in former studies [17,19].…”

Section: Discussionsupporting

confidence: 86%

“…Until now, a number of different free flaps have been described for cheek reconstruction including the ALT [19], RFFF [19], FFF [20] and the scapular/parascapular free flap [21]. Recently, the versatility of the SAFF has been demonstrated for general head and neck reconstruction, and in particular, for cheek and tongue reconstruction [22,23].…”

Section: Discussionmentioning

confidence: 99%

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Outcome in Patients with Partial and Full-Thickness Cheek Defects following Free Flap Reconstruction—A Multicentric Analysis of 47 Cases

Janik

Eljazzar

Faisal

et al. 2020

JCM

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The objective of this study was to evaluate whether the extent of tumor resection and free flap reconstruction influences functional outcome and complications in patients with solid malignancies of the cheek. Therefore, we retrospectively assessed recipient site complications and functional outcomes in 47 patients with solid malignancies of the cheek who underwent either partial (n = 30; 63.8%) or full-thickness (n = 17; 36.2%) cheek resection with free flap reconstruction. Complications occurred in 12 (70.6%) patients after full thickness resections with creation of through-and-through defects compared to 14 (70.6%) patients with partial defects (p = 0.138). Among those 26 patients (55.3%), major recipient site complications, like development of salivary fistula or free flap loss, were observed in 10 (21.3%) and 2 (4.3%) cases, respectively, while minor complications, like wound dehiscence and local infections, were found in 14 (29.8%) and 9 (19.1%) patients. Complications were noticed particularly after reconstruction of suborbital defects (69.2%; p = 0.268), of which occurrence of salivary fistulae was the most common (46.2%; p = 0.035). Similarly, functional outcomes including oral incompetence, ectropion, and trismus were not affected by the extent of resection (p = 0.766). However, oral incompetence was higher in patients with tumors originating from the oral cavity (p = 0.020) and after the performance of mandibulectomy (p = 0.003). Overall, there was no difference in functional outcome or recipient site morbidity between tumor resections resulting in full-thickness and partial defects.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Outcome in Patients with Partial and Full-Thickness Cheek Defects following Free Flap Reconstruction—A Multicentric Analysis of 47 Cases

Janik

Eljazzar

Faisal

et al. 2020

JCM

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“…Five studies assessed the incidence of donor site infection, which was 3.65% (10/274) for ALT patients and 4.74% (10/211) for RFF patients 4,15–18 . Interstudy heterogeneity was moderate (I 2 = 27.9%, P = 0.24).…”

Section: Resultsmentioning

confidence: 99%

“…Four studies compared the incidence of wound dehiscence between ALT patients (4.13%, 9/218) and RFF patients (23.73%, 42/177) 15–18 . Interstudy heterogeneity was moderate (I 2 = 46.1%, P = 0.14).…”

Section: Resultsmentioning

confidence: 99%

Comparison of Donor Site Morbidity Between Anterolateral Thigh and Radial Forearm Free Flaps for Head and Neck Reconstruction: A Systematic Review and Meta-Analysis

Niu

Tao

et al. 2021

Journal of Craniofacial Surgery

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This meta-analysis aimed to provide an up-to-date comparison of donor site morbidity (DSM) between patients who underwent head and neck reconstruction with Anterolateral thigh (ALT) and radial forearm free (RFF) flaps. We searched the PubMed, Web of Science, EMBASE, and Cochrane Library databases to identify studies that compared DSM between ALT and RFF patients. Study quality was assessed using the Newcastle-Ottawa Scale. The pooled odds ratio (OR) of each DSM between ALT and RFF patients was estimated using a random-or fixed-effect model depending on the degree of interstudy heterogeneity. Sensitivity and subgroup analyses were performed if substantial heterogeneity was detected. Eighteen cohort studies with 1,018 patients (535 ALT and 483 RFF patients) were included. Compared with RFF, ALT were associated with lower risks of wound dehiscence (OR ¼ 0.2, 95%CI: 0.10-0.42, P < 0.01), strength impairment (OR ¼ 0.18, 95%CI: 0.07-0.47, P < 0.01), and movement impairment (OR ¼ 0.19, 95%CI:0.07-0.49, P < 0.01). A subgroup analysis showed that ALT were associated with a lower risk of donor site numbness among patients undergoing tongue reconstruction (OR ¼ 0.05, 95%CI: 0.01-0.25, P < 0.01), but not among all patients undergoing head and neck reconstruction. The pooled ORs of other DSMs demonstrated no significant difference between ALT and RFF patients. ALT are superior to RFF for head and neck reconstruction in terms of donor site wound dehiscence, strength impairment, movement impairment, and for tongue reconstruction specifically in terms of donor site numbness. No significant differences in the incidence of donor site hematoma/seroma, infection, or dissatisfaction with donor site appearance were identified between ALT and RFF patients.

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“…The main fasciocutaneous free-flap donor sites are the ALT and the forearm. 24 Lin et al 24 assert that both the ALT and forearm flaps have acceptable success rates but can significantly decrease the quality of life of a patient. Alternatively, the rectus abdominis myocutaneous flap has shown benefit for the reconstruction of massively large defects.…”

Section: Free Flapsmentioning

confidence: 99%

Approach to Reconstruction of Cheek Defects

Başağaoğlu

Bhadkamkar

Hollier

et al. 2018

Seminars in Plastic Surgery

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The cheek is the largest facial unit with a prominent position on the face. Trauma, burns, and the resection of skin cancers constitute common sources of injury, potentially resulting in defects that, through natural healing, produce noticeable scarring. Surgical repair focuses on the reformation of three-dimensional geometries, proper establishment of symmetry, and the minimization of color and texture discrepancies to the surrounding. Defects located in this region may extend to the orbital, nasal, or buccal units and cause unique structural and functional disturbances. Furthermore, without appropriate repair, full-thickness defects involving the buccal mucosa may result in oral dysfunction. In this article, the authors provide a framework to approach various cheek defects and provide a review of the host of ideologies and techniques.

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Experience With the Use of Free Fasciocutaneous Flap in Through-and-Through Cheek-Buccal Defect Reconstruction

Cited by 14 publications

References 26 publications

Outcome in Patients with Partial and Full-Thickness Cheek Defects following Free Flap Reconstruction—A Multicentric Analysis of 47 Cases

Outcome in Patients with Partial and Full-Thickness Cheek Defects following Free Flap Reconstruction—A Multicentric Analysis of 47 Cases

Comparison of Donor Site Morbidity Between Anterolateral Thigh and Radial Forearm Free Flaps for Head and Neck Reconstruction: A Systematic Review and Meta-Analysis

Approach to Reconstruction of Cheek Defects

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