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

Back-up procedures Pedicle flaps Reconstructive surgery Transplant autonomy

Journal

Journal of maxillofacial and oral surgery
ISSN: 0972-8279
Titre abrégé: J Maxillofac Oral Surg
Pays: India
ID NLM: 101538309

Informations de publication

Date de publication:
Mar 2023
Historique:
received: 23 02 2021
accepted: 10 08 2021
medline: 13 4 2023
entrez: 12 4 2023
pubmed: 13 4 2023
Statut: ppublish

Résumé

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. 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. 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. 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. 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. The online version contains supplementary material available at 10.1007/s12663-021-01635-9.

Identifiants

pubmed: 37041957
doi: 10.1007/s12663-021-01635-9
pii: 1635
pmc: PMC10082879
doi:

Types de publication

Journal Article

Langues

eng

Pagination

98-104

Informations de copyright

© The Author(s) 2021.

Déclaration de conflit d'intérêts

Conflict of interestThe authors declare that they have no conflict of interest.Ethical ApprovalAll procedures performed in this study were in accordance with the ethical standards of the institutional research committee (Medical Faculty of University Hospital of Erlangen, registration number 341_20Bc) and with the 1964 Declaration of HELSINKI and its later amendments. All authors declare that they have no conflict of interest.

Références

Clin Plast Surg. 2009 Jul;36(3):443-59
pubmed: 19505613
Plast Reconstr Surg. 1965 Aug;36:173-84
pubmed: 14339173
J Craniomaxillofac Surg. 2018 Sep;46(9):1652-1658
pubmed: 30196862
JAMA Facial Plast Surg. 2015 May-Jun;17(3):209-14
pubmed: 25880793
Semin Plast Surg. 2008 Nov;22(4):269-80
pubmed: 20567703
J Plast Reconstr Aesthet Surg. 2017 Nov;70(11):1547-1555
pubmed: 28712882
J Otolaryngol Head Neck Surg. 2014 Jan 13;43:1
pubmed: 24418459
Chirurg. 2014 Jun;85(6):529-36
pubmed: 24449079
Plast Reconstr Surg. 1998 Sep;102(3):711-21
pubmed: 9727436
Br J Oral Maxillofac Surg. 2006 Jun;44(3):187-92
pubmed: 16095776
Plast Reconstr Surg. 2017 Aug;140(2):371-380
pubmed: 28376026
Oral Oncol. 2011 Jun;47(6):522-7
pubmed: 21498107
Anaesthesia. 2019 Mar;74(3):373-379
pubmed: 30648259
Ann Plast Surg. 2018 Oct;81(4):433-437
pubmed: 29905607
Ann Otol Rhinol Laryngol. 2006 Jan;115(1):35-40
pubmed: 16466098
Am J Surg. 1986 Oct;152(4):430-4
pubmed: 3766877
Oral Oncol. 2005 Jul;41(6):602-6
pubmed: 15975523
Plast Reconstr Surg. 2011 Jan;127 Suppl 1:205S-212S
pubmed: 21200292

Auteurs

G Frohwitter (G)

Department for Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstrasse 11, 91054 Erlangen, Germany.

R Lutz (R)

Department for Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstrasse 11, 91054 Erlangen, Germany.

C Baran (C)

Department for Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstrasse 11, 91054 Erlangen, Germany.

M Weber (M)

Department for Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstrasse 11, 91054 Erlangen, Germany.

C P Nobis (CP)

Department for Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstrasse 11, 91054 Erlangen, Germany.

A Rau (A)

Department for Oral and Maxillofacial Surgery, University Hospital Greifswald, Greifswald, Germany.

M Kesting (M)

Department for Oral and Maxillofacial Surgery, University Hospital Erlangen, Glueckstrasse 11, 91054 Erlangen, Germany.

Classifications MeSH