Clinical Comparison of Scapular, Fibular, and Iliac Crest Osseal Free Flaps in Maxillofacial Reconstructions.
Adolescent
Adult
Aged
Aged, 80 and over
Bone Transplantation
/ methods
Female
Fibula
/ transplantation
Free Tissue Flaps
/ blood supply
Head and Neck Neoplasms
/ complications
Humans
Ilium
/ transplantation
Male
Mandible
/ surgery
Mandibular Injuries
/ surgery
Maxilla
/ injuries
Maxillofacial Injuries
/ etiology
Middle Aged
Oral Surgical Procedures
/ methods
Orbit
/ injuries
Osteotomy
Plastic Surgery Procedures
/ methods
Retrospective Studies
Scapula
/ transplantation
Surgical Wound
/ etiology
Vascularized Composite Allotransplantation
/ methods
Young Adult
Free flap
complications
fibula
head and neck
iliac crest
microvascular reconstruction
scapula
Journal
Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society
ISSN: 1799-7267
Titre abrégé: Scand J Surg
Pays: England
ID NLM: 101144297
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
pubmed:
8
5
2018
medline:
14
6
2019
entrez:
8
5
2018
Statut:
ppublish
Résumé
This study compared the three most used composite flaps in maxillofacial reconstructions in our institute. Between 2000 and 2012, a total of 163 patients with mandibular, maxillary, and orbital defects received either scapular, fibular, or iliac crest osseal reconstructions in Helsinki University Hospital, Departments of Plastic Surgery and Maxillofacial Surgery. Data regarding the patient demographics, complications, and outcomes were analyzed. There were 92 deep circumflex iliac artery flaps (56%), followed by 42 scapular (26%) and 29 fibular flaps (18%). The rate of flap loss was the highest in the deep circumflex iliac artery group (p = 0.001). Reconstructions using fibula were fastest (p = 0.001) and had lowest perioperative blood loss (p = 0.013). There were no significant differences in the number of early or late complications between the flaps, but donor site complications were more severe in deep circumflex iliac artery. Osteotomies as well as dental implants were safely performed in all flaps with equal results. All three flaps of this study can be performed with awareness of the deep circumflex iliac artery flap being the least reliable alternative. The knowledge of the advantages and disadvantages of several osseal-free flap alternatives is beneficial in selecting the best suitable method for each individual patient requiring maxillofacial osseal reconstruction.
Sections du résumé
BACKGROUND AND AIMS:
UNASSIGNED
This study compared the three most used composite flaps in maxillofacial reconstructions in our institute.
PATIENTS AND METHODS:
UNASSIGNED
Between 2000 and 2012, a total of 163 patients with mandibular, maxillary, and orbital defects received either scapular, fibular, or iliac crest osseal reconstructions in Helsinki University Hospital, Departments of Plastic Surgery and Maxillofacial Surgery. Data regarding the patient demographics, complications, and outcomes were analyzed.
RESULTS:
UNASSIGNED
There were 92 deep circumflex iliac artery flaps (56%), followed by 42 scapular (26%) and 29 fibular flaps (18%). The rate of flap loss was the highest in the deep circumflex iliac artery group (p = 0.001). Reconstructions using fibula were fastest (p = 0.001) and had lowest perioperative blood loss (p = 0.013). There were no significant differences in the number of early or late complications between the flaps, but donor site complications were more severe in deep circumflex iliac artery. Osteotomies as well as dental implants were safely performed in all flaps with equal results.
CONCLUSION:
UNASSIGNED
All three flaps of this study can be performed with awareness of the deep circumflex iliac artery flap being the least reliable alternative. The knowledge of the advantages and disadvantages of several osseal-free flap alternatives is beneficial in selecting the best suitable method for each individual patient requiring maxillofacial osseal reconstruction.
Identifiants
pubmed: 29732952
doi: 10.1177/1457496918772365
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM