Superficial Circumflex Iliac Artery-Based Iliac Bone Flap Transfer for Reconstruction of Bony Defects

Yoshimatsu, Hironobu; Iida, Takuya; Yamamoto, Takumi; Hayashi, Akitatsu

doi:10.1055/s-0038-1651489

Cited by 37 publications

(22 citation statements)

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“…They also reported that the average length of the pedicle was 5.5 cm (range: 3.0À8.0 cm). 6 In our 2 cases, the bone defects were both approximately 8 Â 3 cm. The perfusion of the transferred iliac bone flap was similarly confirmed by indocyanine green angiography, and showed good results (Supplementary Digital Content, Fig.…”

Section: Discussionmentioning

confidence: 63%

“…5 Since then, SCIA-based iliac bone flaps have been used for relatively small bony and planar defects, such as the in the orbital floor, the maxilla, the distal phalanx, and the calcaneus. 5,6 This is the first application of SCIA-based iliac bone flap in mandibular reconstruction.…”

mentioning

confidence: 99%

“…With a better understanding of the blood supply to the skin and iliac bone by the SCIA and inclusion of the perforator flap concept, an iliac bone flap utilizing a deep branch of the SCIA was first reported by Iida et al in 2013 5 . Since then, SCIA-based iliac bone flaps have been used for relatively small bony and planar defects, such as the in the orbital floor, the maxilla, the distal phalanx, and the calcaneus 5,6 . This is the first application of SCIA-based iliac bone flap in mandibular reconstruction.…”

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confidence: 99%

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Application of Free Iliac Bone Flap Based on Superficial Circumflex Iliac Perforators in Mandibular Reconstruction

Sakata

Nishioka

Asamura

2021

Journal of Craniofacial Surgery

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were due to biofilm formation by normal skin flora at the time of prosthesis placement.The IA is an alternative to the retromandibular/transparotid approach to install the mandibular component of TMJ replacement devices. Its usage to treat noncomminuted mandibular fractures and to install reconstruction plates are well reported in the literature resulting in no external scarring, lower risk for injury to the facial nerve and parotid gland. 9,20,21 However, it is expected to increase infection rates, since devices will be exposed to oral bacteria during installation.Many protocols have been advocated to reduce the risk of TMJ replacement SSI infections. 15,17,19 Systemic intravenous antibiotic prophylaxis reduces the risk of postoperative infections when performed within 1 hour before surgical incision. 15 Broad spectrum antibiotics such as cefazolin, clindamycin, and cephalosporins are the most used preoperative antibiotics based on their good efficacy against staphylococcal species and uropathogens. 15,17,19 The antibiotics should be continued for 7 to 10 days postoperatively, especially for the high-risk patients. 15,[17][18][19] Irrigation with an antibiotic solution before and after implantation of the device components may also provide some assistance in decreasing the potential for local contamination. 15,18 The antibiotic protocol used in the 5 reported cases included prophylactic and postoperative intravenous cefazolin, combined with oral cephalexin after hospital discharge; in addition, copious irrigation of wounds with saline solution plus gentamycin was performed, which resulted in no case of postoperative SSI infection.The presented cases of benign tumor and severe condylar resorption represent indications of TMJ reconstruction with alloplastic prosthesis and the technical modification to install mandibular components seemed be safe and effective, despite the limited number of cases reported in this study. Customized implants associated with virtual planning allowed safer and easier surgery, decreasing surgical time and improving functional and aesthetics results. Yet, authors emphasize that appropriate selection of patients with careful diagnosis is critical to minimize the risk of TMJ prosthesis failure and postoperative complications.

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Section: Discussionmentioning

confidence: 63%

mentioning

confidence: 99%

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confidence: 99%

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Application of Free Iliac Bone Flap Based on Superficial Circumflex Iliac Perforators in Mandibular Reconstruction

Sakata

Nishioka

Asamura

2021

Journal of Craniofacial Surgery

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“…Cresta Ilíaca. El colgajo microvascuralizado de cresta Ilíaca fue descrito el año 1979 dependiente de la arteria circunfleja ilíaca profunda AICP (Yoshimatsu et al, 2018) mientras el año 2004 Koshima desarrolló el pedículo Tabla II. Recomendaciones de colgajos microvasculares en el territorio maxilofacial, según zona a reconstruir tejidos blando y duro.…”

Section: Introductionunclassified

“…& dependiente de la arteria circunfleja Iliaca superficial (AICS) con la posibilidad de un buen aporte óseo y tejido blando (Koshima et al, 2004;Iida et al, 2013). Este colgajo ha demostrado su versatilidad en distintas zonas de la región maxilofacial con buenos resultados comparables al uso de la fíbula, pero con tamaños óseos menores (Iida et al, 2014;Yoshimatsu et al, 2018), Mücke et al (2013) describe un menor tiempo en comparación al uso de la fíbula, además de un menor tiempo de hospitalización, por lo tanto menor predisposición a infecciones.…”

Section: Introductionunclassified

Colgajos Microvascularizados en Reconstrucción Maxilofacial: Avances de la Microcirugía

Huentequeo-Molina

Pino-Diaz

Moreno-Apablaza

et al. 2018

Int. J. Odontostomat.

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RESUMEN: La reconstrucción de la cabeza y el cuello contempla avances importantes a lo largo de los años. Los colgajos microvasculares se han convertido en la primera opción de tratamiento en grandes defectos del territorio maxilofacial, mientras tanto, la tecnología con el uso de microscopía y luego las imágenes como CT, angiografía por tomografía computarizada, dispositivo ultrasónico, RNM o Doppler contribuyen a lograr una predictibilidad excepcional de estos colgajos microvasculares. Por lo general, la técnica de anastomosis consiste en una sutura de 9-0 en 360°, pero existen autores que han descrito diversos métodos que no son de sutura con un rendimiento aceptable. Existe un buen número de diferentes colgajos microvasculares, cuatro de ellos son los más comunes en la reconstrucción maxilofacial: fíbula, ilíaco, antebrazo radial, escápula. Además el colgajo anterolateral, muy útil en defectos de piel y tejidos blandos. La evolución de los colgajos microvasculares implica los colgajos quiméricos, muy útiles en defectos grandes. El objetivo de este artículo es describir y exponer el desarrollo de la microcirugía y las diversas opciones de colgajos microvasculares en la reconstrucción maxilofacial.

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Head and neck reconstruction with the superficial circumflex iliac artery perforator (SCIP) free flap: Lessons learned after 73 cases

Scaglioni,

Meroni,

Tomasetti

et al. 2024

Head & Neck

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BackgroundHead and neck tissue defects after ablative surgery often require complex and composite reconstructions. The superficial circumflex iliac artery perforator (SCIP) flap is an extremely versatile perforator‐based flap with minimal donor site morbidity, which may represent the optimal procedure in this setting. Over the last 5 years, we collected a large base of experience, including both simple and chimeric SCIP‐based reconstruction, making this flap our first choice for head and neck reconstructions.Patients and MethodsSeventy‐three patients undergoing ablative head and neck surgery for oncologic pathologies were treated by means of a SCIP flap reconstruction. Patients' mean age was 67 years old (range 37–89), 51 were males and 22 were females. Fifty‐eight flaps were simple and 15 were chimeric reconstruction patterns. Indocyanine green perfusion imaging was performed in all cases.ResultsAll the patients were successfully treated with no flap losses were encountered. Twelve patients encountered postoperative complications: in four cases revision surgery was required for venous congestion, while the remaining cases were managed conservatively (four wound dehiscence and three infections). No patients showed donor site complications. The mean follow‐up period was 11 months (range 3–24).ConclusionsOur case series demonstrates the reliability and versatility of the SCIP flap for different kinds of head and neck reconstructions. The chimeric options combined with bone, double skin paddle, and muscle offer a broad variety of functional reconstructive solutions for complex head and neck surgeries. Intraoperative indocyanine green perfusion examination provides a valuable tool to assess and ascertain proper vascularization and post‐anastomosis vessel patency in complex microvascular flap‐based reconstructions.

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Superficial Circumflex Iliac Artery-Based Iliac Bone Flap Transfer for Reconstruction of Bony Defects

Cited by 37 publications

References 25 publications

Application of Free Iliac Bone Flap Based on Superficial Circumflex Iliac Perforators in Mandibular Reconstruction

Application of Free Iliac Bone Flap Based on Superficial Circumflex Iliac Perforators in Mandibular Reconstruction

Colgajos Microvascularizados en Reconstrucción Maxilofacial: Avances de la Microcirugía

Head and neck reconstruction with the superficial circumflex iliac artery perforator (SCIP) free flap: Lessons learned after 73 cases

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