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Complex Orofacial Reconstruction with the Intrinsic Chimeric Flap
- Source :
- Journal of Reconstructive Microsurgery. 33:233-243
- Publication Year :
- 2017
- Publisher :
- Georg Thieme Verlag KG, 2017.
-
Abstract
- Background Ablation of locally advanced or recurrent head and neck cancer often results in large composite orofacial defects with limited recipient vessels. These complex defects lend well to intrinsic chimeric flap reconstruction, which allows greater ability to inset various flap component tissue types than composite flaps and requires only one set of microvascular anastomoses. Methods A retrospective chart review was performed on all patients who underwent orofacial reconstruction with an intrinsic chimeric free flap from 2002 to 2015. Flaps with only one tissue type, such as two separate skin paddles with no additional component, were not considered chimeric flaps and therefore not included in this report. Patient demographic data, defect, and flap characteristics, as well as complications and outcomes were analyzed to create a guide for flap selection. Univariate and multivariate analysis was performed to determine risk factors for flap take-back and failure. Results Seventy-five patients underwent orofacial intrinsic chimeric free flap reconstruction. Results were organized based on defect characteristics to create a guide for flap selection. The number of chimeric flap components and operation duration were independently statistically associated with flap take-backs ( p Conclusions Intrinsic chimeric flaps provide a versatile and elegant reconstructive option for a variety of complex orofacial defects. We provide a guide to facilitate decision making in flap selection for these challenging reconstructions and report factors associated with flap take-backs and losses.
- Subjects :
- Adult
Male
Microsurgery
medicine.medical_specialty
Soft Tissue Injuries
Adolescent
Patient demographics
medicine.medical_treatment
Locally advanced
Free flap
030230 surgery
Anastomosis
Free Tissue Flaps
Surgical Flaps
Young Adult
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Chart review
medicine
Humans
Child
Facial Injuries
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Middle Aged
Plastic Surgery Procedures
eye diseases
Surgery
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Free flap reconstruction
Tissue type
Female
business
Perforator Flap
Subjects
Details
- ISSN :
- 10988947 and 0743684X
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- Journal of Reconstructive Microsurgery
- Accession number :
- edsair.doi.dedup.....835ea0fef331f1066e896f20f484e472