scholarly journals Single-Stage Peninsula-Shaped Lateral Tongue Flap Reconstruction for Buccal Defects in Two Patients: Revisiting a Simple and Safe Reconstructive Option

2021 ◽  
Vol 17 (2) ◽  
pp. 115-119
Author(s):  
Yu Taek Kong ◽  
Soo Yeon Lim ◽  
Junekyu Kim ◽  
Hyun Woo Shin ◽  
Kyu Nam Kim
Keyword(s):  
Free Flaps ◽  
Good Alternative ◽  
Single Stage ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Tongue Flap ◽  
Adenoid Cystic ◽  
Reconstructive Option ◽  
Buccal Squamous Cell Carcinoma

Intraoral defects are increasingly reconstructed using free flaps. However, certain situations may render free flap reconstruction difficult. This study presents two cases with underlying comorbidities that underwent reconstruction of buccal defects involving the retromolar trigone (RMT), using a single-stage peninsula-shaped lateral tongue flap (pLTF). A 58-year-old woman and a 75-year-old man were diagnosed with left buccal squamous cell carcinoma and right buccal adenoid cystic carcinoma, respectively. The buccal defects extending to the RMT area were detected and covered with an ipsilateral posteriorly based pLTF after wide excision of the lesion. All flaps survived without any postoperative complications. Moreover, no tumor recurrences or functional problems were observed during the final follow-up. A single-stage pLTF is believed to represent a good alternative to free flaps in buccal and RMT defects.

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.

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

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 Tongue flap- a good choice for intraoral reconstruction after marginal mandibulectomy: a single institution retrospective study of 27 cases

2019 ◽  
Vol 5 (5) ◽  
pp. 1217
Author(s):  
Gopu Govindhasamy ◽  
Subbiah Shanmugam ◽  
Rajiv Michael
Keyword(s):  
Functional Outcomes ◽  
Primary Tumour ◽  
Donor Site ◽  
Good Choice ◽  
Soft Tissue Reconstruction ◽  
Flap Reconstruction ◽  
Tongue Flap ◽  
Marginal Mandibulectomy

<p class="abstract"><strong>Background:</strong> Marginal mandibulectomy with wide excision of the primary tumour in the treatment of the oral cavity squamous cell cancers preserves the form and function of the mandible, without compromise in obtaining oncologically safe margins. Of the various methods of reconstruction of the composite intraoral tissue defect, tongue flaps offer an easy and effective method of reconstruction.</p><p class="abstract"><strong>Methods:</strong> We have collected the records of 27 patients who underwent marginal mandibulectomy and tongue flap reconstruction in the last 6 years from the cancer department master case sheets, operative records and follow up records. The information on the immediate and long term complications were obtained from the records and functional outcomes of patients were recorded at the time of last follow up and analysed. All the 27 patients had horizontal marginal mandibulectomy with an anteriorly or posteriorly based tongue flap reconstruction.  </p><p class="abstract"><strong>Results:</strong> The most common early postoperative complication was infection around the flap site that occurred in 18.5% of patients. The other complications including haemorrhage, flap dehiscence occurred in few patients which were managed effectively. There was no incidence of major flap necrosis. Speech and swallowing difficulty was encountered in 18.5% and 14.8% of patients respectively. The long term complications were managed conservatively with speech and swallowing therapy.</p><strong>Conclusions:</strong>In our experience, tongue is an excellent donor site for intraoral soft tissue reconstruction, providing an analogous tissue for reconstruction. The technique is simple with acceptable rates of immediate and long term complications and with good functional outcomes.<p> </p>

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.

Does Cigarette Smoking Harm Microsurgical Free Flap Reconstruction?

2018 ◽  
Vol 34 (07) ◽  
pp. 492-498 ◽  
Author(s):  
Paul Heidekrueger ◽  
Elisabeth Haas ◽  
Michaela Coenen ◽  
Riccardo Giunta ◽  
Milomir Ninkovic ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
Free Flap ◽  
Smoking Status ◽  
Free Flaps ◽  
Negative Influence ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Wide Range ◽  
American Society ◽  
The Impact

Background Free tissue transfers can successfully address a wide range of reconstructive requirements. While the negative influence of cigarette smoking is well documented, its effects in the setting of microsurgical free flap reconstruction remain debated. This study evaluates the impact of cigarette smoking on microsurgical reconstructions. Methods Over a 7-year period, 897 patients underwent 969 microvascular free flap reconstructions at a single surgical center. The cases were divided into “smoker” (S) and “nonsmoker” (NS) groups according to their cigarette smoking status. The data were retrospectively screened for patients' demographics, perioperative details, surgical complications, free flap types, recipient sites, flap survival, and overall outcomes. Results Both groups were comparable regarding comorbidities including hypertension, peripheral artery disease, diabetes, American Society of Anesthesiologists scores, types of performed free flaps, and recipient sites. While patients in the NS group were significantly older and had a higher prevalence of obesity (p < 0.05), there were no significant differences regarding the rate of major or minor complications during our 3-month follow-up period (p > 0.05). Conclusion While minor and major complications were increased regarding virtually all examined parameters, cigarette smoking did not have significant effects on the overall outcomes of microsurgical free flap reconstructions.

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