scholarly journals Free Flap Reconstruction of the Maxilla

2019 ◽  
Vol 33 (01) ◽  
pp. 030-037 ◽  
Author(s):  
Aurora Vincent ◽  
Jason Burkes ◽  
Fayette Williams ◽  
Yadranko Ducic
Keyword(s):  
Free Flap ◽  
Free Flaps ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Flap Transfer ◽  
Regular Diet ◽  
Free Flap Transfer ◽  
Intelligible Speech

AbstractTumors of the maxilla and midface are some of the most difficult to manage, not only in terms of treatment but also in terms of achieving acceptable orofacial reconstruction. Today, free flaps dominate the reconstructive field. Many patients can achieve successful reconstruction after free flap transfer with a return of intelligible speech, a regular diet, and acceptable cosmesis. Herein, the authors review free flap reconstruction of the maxilla, with a focus on the classifications of defects, when obturators are appropriate, types and sources of free flaps, and complications for which to beware.

Pain Relief after Free Flap Reconstruction in Adriamycin Necrosis on the Dorsum of the Hand. A Case Report

1989 ◽  
Vol 14 (1) ◽  
pp. 45-46 ◽  
Author(s):  
H. Nettelblad ◽  
L-E. Karlander ◽  
G. Nylander
Keyword(s):  
Case Report ◽  
Pain Relief ◽  
Free Flap ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Flap Transfer ◽  
Free Flap Transfer

A free flap transfer in a case of Adriamycin necrosis on the dorsum of the hand is reported. The advantages of this method of reconstruction are discussed.

scholarly journals Free flap transfer, a safe and efficient method for reconstruction of composite skull base defects after salvage resection of advanced intra- and extracranial communicating tumors

2021 ◽  
Author(s):  
Hou jie Liu ◽  
Xue-Ji Li ◽  
Hai-Peng Qian ◽  
Chang-Ming An ◽  
De-Zhi Li ◽  
...  
Keyword(s):  
Skull Base ◽  
Free Flap ◽  
Tumor Resection ◽  
Anterolateral Thigh Flap ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Flap Transfer ◽  
Salvage Resection ◽  
Free Flap Transfer ◽  
Skull Base Defects

Abstract Propose: Surgical treatment of advanced intra- and extracranial communicating skull base tumors is challenging, especially for the reconstruction of the large composite defect left by tumor resection. The aim of the study is to evaluate the utility of the free flap reconstruction of the defects resulting from radical resection of these tumors. Methods: The clinical data of 17 consecutive patients who underwent free flap reconstruction for defect left by salvage resection of advanced intra- and extracranial communicating tumors from 2013 to 2019 were retrospectively collected and analyzed. Results: There were 5 squamous cell carcinomas, 4 adenoid cystic carcinomas, 2 basal cell carcinomas, 2 meningiomas, 1 anaplastic hemangiopericytoma, 1 pleomorphic adenoma, 1 osteosarcoma and 1 chondrosarcoma. All patients had recurrent neoplasms, 2 of which had pulmonary metastasis. A modified radical cervical dissection was performed in 6 patients. The anterolateral thigh flap myocutaneous (ALT) flap and rectus abdominis myocutaneous (RAM) flap were used in 15 patients (88.2%) and 2 patients (11.8%), respectively. Complications were seen in 3 of 17 patients (17.6%) with 1 total flap loss. The median PFS duration was 31 months. The 3- and 5-year PFS rate was 0.47 and 0.24, respectively. The mean OS duration was 66 months. The 3- and 5-year OS rate was 0.85 and 0.68, respectively. Conclusion: Free flap transfer is a safe and effective method with acceptable complications, useful for reconstruction of large composite skull base defects after salvage resection of advanced intra- and extracranial communicating tumors. The functional and cosmetic results are satisfying.

scholarly journals Use of the Anterolateral Thigh in Cranio-Orbitofacial Reconstruction

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
William J. Parkes ◽  
Howard Krein ◽  
Ryan Heffelfinger ◽  
Joseph Curry
Keyword(s):  
Free Flap ◽  
Case Series ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Tissue Loss ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Anterolateral Thigh ◽  
The Many ◽  
Soft Tissue Loss

Objective. To detail the clinical outcomes of a series of patients having undergone free flap reconstruction of the orbit and periorbita and highlight the anterolateral thigh (ALT) as a workhorse for addressing defects in this region. Methods. A review of 47 patients who underwent free flap reconstruction for orbital or periorbital defects between September 2006 and May 2011 was performed. Data reviewed included demographics, defect characteristics, free flap used, additional reconstructive techniques employed, length of stay, complications, and follow-up. The ALT subset of the case series was the focus of the data reviewed for this paper. Selected cases were described to highlight some of the advantages of employing the ALT for cranio-orbitofacial reconstruction. Results. 51 free flaps in 47 patients were reviewed. 38 cases required orbital exenteration. The ALT was used in 33 patients. Complications included 1 hematoma, 2 wound infections, 3 CSF leaks, and 3 flap failures. Conclusions. Free tissue transfer allows for the safe and effective reconstruction of complex defects of the orbit and periorbital structures. Reconstructive choice is dependent upon the extent of soft tissue loss, midfacial bone loss, and skullbase involvement. The ALT provides a versatile option to reconstruct the many cranio-orbitofacial defects encountered.

The Role of Free Flaps in the Treatment of Persistent Scalp Osteomyelitis

2006 ◽  
Vol 59 (suppl_1) ◽  
pp. ONS-64-ONS-67 ◽  
Author(s):  
Willy D. Boeckx ◽  
René R.W.J. van der Hulst ◽  
Lloyd V. Nanhekhan ◽  
Francesca De Lorenzi
Keyword(s):  
Free Flap ◽  
Donor Site ◽  
Muscle Flap ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Surgical Debridement ◽  
Neurosurgical Procedures ◽  
Latissimus Dorsi Muscle Flap ◽  
Flap Transfer ◽  
Free Flap Transfer

Abstract OBJECTIVE: To evaluate the efficacy of the combination of an extensive surgical debridement and simultaneous free flap repair in case of troublesome cranial osteomyelitis. METHODS: Five patients with persistent, frontal bone osteomyelitis were treated with surgical debridement of the infected bone and reconstruction with a free flap. In all patients, osteomyelitis occurred after neurosurgical procedures and lasted from 1 to 7 years. A latissimus dorsi muscle flap with a split skin graft has been performed. RESULTS: No flap failure occurred and donor site morbidity was negligible. No signs of osteomyelitis or soft tissue infection were observed during the mean follow-up period of 3.2 years. Furthermore, the contour of the cranium could be preserved without a need for bone grafts or implants. CONCLUSION: In our experience, the combination of an extensive surgical debridement and a free flap transfer is demonstrated to be an effective treatment for “chronic” osteomyelitis of the cranium.

scholarly journals Reconstruction with free flaps in robotic head-and-neck onco-surgeries

2018 ◽  
Vol 51 (03) ◽  
pp. 283-289 ◽  
Author(s):  
Rajan Arora ◽  
Vinay Kumar Verma ◽  
Kripa Shanker Mishra ◽  
Hemant Bhoye ◽  
Rahul Kapoor
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Dissection ◽  
Neck Cancer ◽  
Free Flap ◽  
Free Flaps ◽  
Cancer Surgery ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Good Outcome

ABSTRACT Aims and Objective: The aim of the present article is to highlight how reconstruction with free flaps is different and difficult in cases with robotic head-and-neck cancer surgery. It also highlights the technical guidelines on how to manage the difficulties. Materials and Methods: Eleven patients with oropharyngeal cancer having undergone tumour excision followed by free-flap reconstruction been reviewed here. Nine patients had tumour excision done robotically through intraoral route while neck dissection done with transverse neck crease incision. There is a problem of difficult flap inset in this group of patient. Two patients had intraoral excision of tumour followed by robotic neck dissection via retroauricular incision. With no incision directly on the neck, microvascular anastomosis is challenging in this set of patients. Free flap was used in all the cases to reconstruct the defect. Results: Successful reconstruction with free flap was done in all the cases with good outcome both functionally and aesthetically. Conclusion: Free-flap reconstruction is possible in robotic head-and-neck cancer surgery despite small and difficult access, but it does need practice and some technical modifications for good outcome.

O147 The use of free flaps based on the thoracodorsal artery for free flap reconstruction

2007 ◽  
Vol 2 (1) ◽  
pp. 109
Author(s):  
R. Anand ◽  
M. Ethunandan ◽  
P. Ramchandani ◽  
V. Ilankovan
Keyword(s):  
Free Flap ◽  
Free Flaps ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Thoracodorsal Artery

Functional Evaluation of Nonsensate Free Flaps to the Sole of the Foot

Foot & Ankle ◽  
1986 ◽  
Vol 7 (2) ◽  
pp. 118-123 ◽  
Author(s):  
Ramesh Gidumal ◽  
Allen Carl ◽  
Phillip Evanski ◽  
William Shaw ◽  
Theodore R. Waugh
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Older Patients ◽  
Free Flaps ◽  
Functional Evaluation ◽  
Soft Tissue Defects ◽  
Flap Transfer ◽  
Free Flap Transfer ◽  
Tissue Defects ◽  
Sole Of The Foot

Free flap transfer for soft tissue defects involving the sole of the foot have been important in limb salvage. The functional capacity of 16 patients is documented. From our data, free flaps to weightbearing surfaces of the foot give satisfactory results in patients less than 40 years old and salvage is rewarding. Older patients had less than satisfactory results. When the only alternative is an amputation, free flap salvage may still be indicated.

498 The Bristol Sign - A Technical Tip to Confirm Skin Flap Vascularity

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Timothy Schrire ◽  
Ahmed Emam ◽  
Giulia Colavitti ◽  
Umraz Khan
Keyword(s):  
Free Flap ◽  
Gold Standard ◽  
Skin Flap ◽  
Free Flaps ◽  
Modern Medicine ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Central Tenet ◽  
Tissue Defects

Abstract Introduction In modern medicine, free flap reconstruction has become the gold standard when faced with soft tissue defects. The impressive cosmesis, and adaptability of free flaps means that we can securely state that we are in the era of Plastic Surgery defined by free flap reconstruction. However, as part of free flap reconstruction, clinical monitoring of the flap is a central tenet post-operatively. Different departments have different protocols for this. Method In our unit, it is practice to insert a single interrupted stitch overlying the Doppler site just before dressings. This localises the site of the pedicle for Doppler monitoring, and allows the surgeon to examine the quality of the blood droplets, demonstrating flap perfusion. Results The use of the stitch is considered practical, replicable, and safe, and aids in providing gold standard monitoring post-operatively. The additional analysis of the blood droplet is another sign, in itself, of a healthy flap, and excludes venous congestion. Conclusions The Bristol stitch is a useful adjunct to free flap reconstruction. It’s localisation of the Doppler signal allows medical and nursing staff to confidently approach post-operative monitoring, and the blood elicited by the stitch insertion is a useful sign of flap vascularity and venous status.

scholarly journals Current evidence for outcomes of free-flap reconstruction in factor V Leiden patients

2019 ◽  
Vol 2 (2) ◽  
pp. 58-66
Author(s):  
Isobel Yeap ◽  
Chris Ahn ◽  
Stuart Hoffman ◽  
Rowan Gillies ◽  
John Vandervord
Keyword(s):  
Free Flap ◽  
Factor V Leiden ◽  
Free Flaps ◽  
Current Evidence ◽  
Factor V ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Flap Surgery ◽  
Flap Failure ◽  
Free Flap Surgery

Background: Factor V Leiden is the most common form of inherited thrombophilic syndrome, affecting five per cent of caucasians. While increased rates of venous thromboembolic complications have been regularly reported in factor V Leiden patients, little is known about their risk of microvascular complications or flap failure rates in free-flap surgery. The aim of this review is to qualitatively review the published literature on outcomes of free-flap surgery in patients with factor V Leiden. Methods: MEDLINE®, PubMed, EMBASE and Cochrane were searched from their dates of inception to March 2017. Nine studies of level IV evidence were included in this qualitative review. In total, these studies included 22 patients who underwent 24 free-flap operations. Results: Nine flap failures were reported due to thrombotic complications. Even heterozygous factor V Leiden patients had a relatively high risk of free-flap failure (3/15 free flaps), and patients who were heterozygous for factor V Leiden and had other coexistent thrombophilias had an even higher failure rate (5/6 free flaps). However, the small sample size across the nine studies, as well as the inevitable publication bias, means that definitive conclusions cannot be drawn. Conclusion: Despite factor V Leiden being a relatively common condition in Australia, current evidence for outcomes of free-flap reconstruction in this patient population is lacking.

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