To review complications and outcomes associated with latissimus-serratus-rib free flap oromandibular and midface reconstruction.Design: Retrospective medical record review.Setting: Two academic tertiary care medical centers.Patients: Twenty-eight patients with segmental resection of the mandible and 1 patient with combined resection of the mandible and maxilla after excision of neoplasms of the oralcavity,whowerebelievedtobepoorcandidatesforfibula free flap reconstruction, were identified.Interventions: Twenty-seven latissimus-serratus-rib osteomusculocutaneous free flap reconstructions and 2 serratus-rib osteomuscular free flap reconstructions were performed.
Main Outcome Measures:The outcome of micro-vascular free tissue transfer as well as short-and longterm complications were recorded.Results: There were no perioperative free flap failures. Delayed partial rib graft resorption occurred in 1 patient 33 months after free flap transfer for maxillary reconstruction. Among 28 cases of mandibular reconstruction, 1 case of bone graft nonunion was noted after a postoperative period of 57 months. All other cases achieved successful restoration of mandibular continuity. Donor site morbidity was well-tolerated in all patients.
Conclusion:Latissimus-serratus-rib osteomusculocutaneous free flaps are effective for reconstruction of composite defects of the mandible in patients who are not candidates for more commonly used vascularized bonecontaining free flaps.