Reconstruction of complex oro-mandibular defects by four different modifications of free fibula osteomyocutaneous flap: A prudent alternative to multiple flaps

Chatterjee, Dipmalya; Rahman, Ziaur; Harsha, K.N.; Sharma, Jayesh; Rai, Rashmi; Menon, Akash

doi:10.1016/j.bjps.2022.04.060

Cited by 4 publications

(2 citation statements)

References 39 publications

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“…In our series, only class II and class III mandibulectomies were performed and condyles were always preserved. Surgical defects of the oral cavity were primarily reconstructed with microvascular fibulafree flaps which have the advantages of consistent shape, wide length, and distant location that allows a two-team approach at the same time and low donor-site morbidity [20][21][22]. A fibula-free flap inset starts with the fixation of the plate previously modeled, followed by the fitting of the fibular flap.…”

Section: Methodsmentioning

confidence: 99%

Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template

Tatti,

Carta,

Bontempi

et al. 2024

JPM

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Introduction: The present study evaluates the influence of virtual surgical planning with a preoperative 3D resin model on aesthetic and functional outcomes in patients treated by segmental mandibulectomy and reconstruction with fibula-free flap for oral cancer. Methods: All consecutive patients who underwent segmental mandibulectomy and mandibular reconstruction with a fibula-free flap using a 3D template at our department from January 2021 to January 2023 were included in the study. “Patients control” were patients treated by reconstruction with a fibula-free flap without using a 3D template. Three-dimensional modeling was performed by converting from preoperative computed tomography to a stereolithography format to obtain the resin 3D models. Qualitative analysis of anatomical and aesthetic results consisted of the evaluation of the patients’ aesthetic and functional satisfaction and the symmetry of the mandibular contour observed at clinical examination. Quantitative analysis was based on the assessment of the accuracy and precision of the reconstruction by comparing preoperative and postoperative computed tomograms as objective indicators. Results: Seven patients (five males and two females, mean age of 65.1 years) were included in the study. All patients showed a symmetric mandibular contour based on the clinical examination. After recovery, six patients (85.7%) considered themselves aesthetically satisfied. The quantitative analysis (assessed in six/seven patients) showed that the mean difference between preoperative and postoperative intercondylar distance, intergonial angle distance, anteroposterior dimension, and gonial angle improved in the 3D template-assisted group. Conclusion: The 3D-printed template for mandibular reconstruction with microvascular fibula-free flap can improve aesthetic outcomes in comparison with standard approaches.

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Section: Methodsmentioning

confidence: 99%

Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template

Tatti,

Carta,

Bontempi

et al. 2024

JPM

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“…According to our experiences, it is recommended to limit the acceptable width of skin defects in the legs of young adults to a maximum of 3 cm because of the strength of muscles in this region. If the width of skin paddle is larger than 3 cm, excessive suture tension wound led to several leg wound complications, such as delayed healing, wound dehiscence, and skin necrosis (8)(9)(10). In cases of wide skin defect, leg wounds have been closed using either mattress-sutures or skin grafts.…”

Section: Introductionmentioning

confidence: 99%

The fusiform skin paddle in fibula free flap: a fusiform-designed skin paddle for maxillofacial soft defect reconstruction and reducing leg wound tension

Li,

Zheng,

Cheng

et al. 2024

Front. Oncol.

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ObjectiveTo investigate the feasibility of leg wound closure and reconstruction of maxillofacial soft defect by a fusiform-designed skin paddle in fibula free flap (FFF).MethodsFifty patients who underwent FFF for reconstruction of maxillofacial soft defect were divided into two groups. The fusiform group (20 patients) was treated using a fusiform-designed skin paddle in FFF (skin paddle width less than 2 cm), and leg wound was closed using primary suturing. Reconstruction of the maxillofacial soft defect or filling of dead space was achieved by folding the fusiform skin paddle. The conventional group (30 patients) was treated using the conventional-designed skin paddle (skin paddle width no less than 2.5 cm). The leg wound was closed using mattress suturing or skin graft, while reconstruction of the maxillofacial soft defect or filling of dead space by conventional way. The average postoperative length of hospital stay, healing time of leg wound, and post-surgical complications were recorded at least 6 months after the surgery.ResultsCompared with traditional method, the fusiform-designed skin paddle reduced the average healing time of the leg wound (fusiform group: 11.05 days, conventional group: 14.77 days, P < 0.05). The average length-to-width ratio in fusiform group was significantly greater than that of in conventional group (fusiform group: 5.85, conventional group: 2.93, P < 0.05), and no difference was observed on the graft size of skin paddle between two groups (fusiform group: 23.13, conventional group: 27.13, P > 0.05). The post-surgical early complications of the leg wound in the conventional group were higher than that of in the fusiform group (fusiform group: 0%, conventional group: 6.67%), while the post-surgical late complication of the donor site between the two groups showed no case. Healing disorders of maxillofacial soft reconstruction in the conventional group were higher than that of in the fusiform group (fusiform group: 5.26%, conventional group: 20.69%).ConclusionsFusiform-designed skin paddle for closure of the leg wound and maxillofacial soft defect is a feasible alternative to the conventional- designed skin paddle. The fusiform- designed skin paddle resulted in the less postoperative length of hospital stay, shorter healing time of leg wound and less complication.

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Introduction and preliminary application report for a novel 3D printed perforator navigator for fibular flap surgery

Wei,

Zhu,

et al. 2023

Journal of Cranio-Maxillofacial Surgery

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Reconstruction of complex oro-mandibular defects by four different modifications of free fibula osteomyocutaneous flap: A prudent alternative to multiple flaps

Cited by 4 publications

References 39 publications

Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template

Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template

The fusiform skin paddle in fibula free flap: a fusiform-designed skin paddle for maxillofacial soft defect reconstruction and reducing leg wound tension

Introduction and preliminary application report for a novel 3D printed perforator navigator for fibular flap surgery

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