Single flap reconstruction for complex oro-facial defects using chimeric free fibular flap variants

Summary In this article, we describe the use of chimeric free fibular flaps to reconstruct three-dimensional spatial defects in the orofacial region. Recent insights into permutations possible with the chimeric fibular flap have allowed us to achieve our reconstructive objectives with a single chime...

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Bibliographic Details
Published in:Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2013-03, Vol.66 (3), p.358-363
Main Authors: Kannan, R.Y, Mathur, B.S, Tzafetta, K
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Bone Transplantation - methods
Chimeric flaps
Cohort Studies
Facial Neoplasms - surgery
Female
Fibula - surgery
Fibula - transplantation
Fibular flap
Follow-Up Studies
Free Tissue Flaps - blood supply
Graft Rejection
Graft Survival
Humans
Male
Mandibular Neoplasms - surgery
Mandibular Reconstruction - methods
Maxillary Neoplasms - surgery
Middle Aged
Mouth Neoplasms - surgery
Orofacial defects
Plastic Surgery
Postoperative Complications - epidemiology
Postoperative Complications - physiopathology
Quality of Life
Retrospective Studies
Risk Assessment
Skin Transplantation - methods
Wound Healing - physiology
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Summary:Summary In this article, we describe the use of chimeric free fibular flaps to reconstruct three-dimensional spatial defects in the orofacial region. Recent insights into permutations possible with the chimeric fibular flap have allowed us to achieve our reconstructive objectives with a single chimeric flap and minimise donor-site morbidity as well as operating time. In an overall series of 34 free fibular flaps from 2009 to 2012, we performed twelve cases of free chimeric fibular flaps with osseo-myo-cutaneous/OMC ( n  = 7), multi-pedicled osseo-musculo-cutaneous/Mp-OMC ( n  = 4) and multi-pedicled osseo-cutaneous/Mp-OC ( n  = 1) variants for either post-excisional defects or osteo-radionecroses. We had an overall flap survival rate of 100% with one partial flap loss due to the ‘puppeteer’ effect. Based on our experiences, we find the chimeric fibular flap to be an excellent addition to our reconstructive arsenal for complex orofacial defects.
ISSN:1748-6815
1878-0539
DOI:10.1016/j.bjps.2012.10.012