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

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 66; no. 3; pp. 358 - 363
• Main Authors: Kannan, R.Y, Mathur, B.S, Tzafetta, K
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.03.2013
• 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; Fibular flap; Chimeric flaps; Orofacial defects
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2012.10.012

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.