Consistent Value of Two-Stage Pedicle Flaps in the Age of Microsurgical Maxillofacial Reconstruction

Introduction Up to the second half of the twentieth century, pedicled flaps marked the gold standard in reconstructive surgery. Followed by the introduction of microsurgical techniques, these flaps were increasingly abandoned. We conducted a retrospective study to determine the value of two-stage pe...

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Bibliographic Details
Published in:Journal of maxillofacial and oral surgery 2023-03, Vol.22 (Suppl 1), p.98-104
Main Authors: Frohwitter, G., Lutz, R., Baran, C., Weber, M., Nobis, C. P., Rau, A., Kesting, M.
Format: Article
Language:English
Subjects:
Anesthesia
Dentistry
Dissection
Fistula
Medical records
Medicine
Medicine & Public Health
Microsurgery
Oral and Maxillofacial Surgery
Original
Original Article
Otorhinolaryngology
Patients
Plastic Surgery
Reconstructive surgery
Skin
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Summary:Introduction Up to the second half of the twentieth century, pedicled flaps marked the gold standard in reconstructive surgery. Followed by the introduction of microsurgical techniques, these flaps were increasingly abandoned. We conducted a retrospective study to determine the value of two-stage pedicle flaps in modern maxillofacial reconstruction. Material & Methods A chart review from October 2017 to November 2020 was performed to identify patients who were treated by a two-stage pedicle flap in our Department of Oral and Maxillofacial Surgery. Results A total of 31 patients, 17 female and 14 males received 36 two-stage pedicle flaps. All patients were in noticeably impaired health condition with a majority of ASA-score 3. The defect location mainly contained extraoral resections (58.3%). A variety of flaps were harvested consisting of buccal flaps, Abbe flaps, forehead flaps, deltopectoral flaps, nasolabial flaps, and a tubed flap. Discussion The study outlines two indications for the use of two-stage pedicle flaps. Firstly, as a back-up strategy in heavily pre-treated wound beds and secondly in an almost contrarily indication as a first-choice reconstructive option of the facial skin in esthetic demanding cases. Conclusion The timesaving and straight forward surgical approach as well as their low postsurgical complications and strong long-time success rates secure the two-stage pedicle flap a justified niche role in times of microsurgical maxillofacial reconstruction.
ISSN:0972-8279
0974-942X
DOI:10.1007/s12663-021-01635-9