scholarly journals Facial contouring with parascapular free flap: A case series of 22 cases

2013 ◽  
Vol 46 (03) ◽  
pp. 561-567 ◽  
Author(s):  
Guru Dayal Singh Kalra ◽  
Ram Krishna Gupta
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Donor Site ◽  
Case Series ◽  
Facial Asymmetry ◽  
Free Flaps ◽  
Soft Tissue Augmentation ◽  
Facial Soft Tissue ◽  
Skin Paddle ◽  
Hemifacial Atrophy

ABSTRACT Background: The facial asymmetry correction in complex craniofacial malformations presents a challenging problem for reconstructive surgeons. Progressive hemifacial atrophy (HFA) and hemifacial microsomia (HFM) can manifest in different grades of severity. Most patients require only soft-tissue augmentation. Free flaps are the best option for correction of severe facial soft-tissue deficiency. Materials and Methods: Twenty-two patients of HFM and HFA were included in this study from January 2006 to March 2009 in the Department of Plastic and Reconstructive Surgery, SMS Medical College and Hospital. In all cases, atrophy correction was done using de-epithelialised parascapular free flap with the de-epithelialised surface was placed under the skin. A small skin paddle was taken for monitoring. Results: All cases were reconstructed with de-epithelialised parascapular free flap. There was no flap loss in this series. Hematoma was noted in five cases. Debulking and removal of skin paddle were done in all cases after 6 months. Atrophy recurrence was not observed in any of the cases on follow-up. Conclusion: Contouring of face in cases of HMF and HFA is satisfactorily done with the parascapular free flap. It gives better cosmetic results with minimal donor site morbidity. Facial vessels are better recipient vessels for anastomosis. Keeping de-epithelialised surface of flap under the skin helped in preventing sagging.

A novel Split-Thickness Skin Graft Donor Site

2009 ◽  
Vol 141 (3) ◽  
pp. 390-394 ◽  
Author(s):  
Tamer A. Ghanem ◽  
Mark K. Wax
Keyword(s):  
Skin Graft ◽  
Reverse Flow ◽  
Donor Site ◽  
Tertiary Care ◽  
Case Series ◽  
Free Flaps ◽  
Split Thickness Skin Graft ◽  
Skin Paddle ◽  
Forearm Flap ◽  
Thickness Skin

OBJECTIVE: To eliminate morbidity of the thigh split-thickness skin graft (STSG) donor site in forearm flaps, the feasibility of harvesting from an alternate site was assessed. STUDY DESIGN: Case series with planned data collection. SETTING: A tertiary care academic setting. SUBJECTS AND METHODS: Data were collected from patients undergoing forearm flap reconstruction over 13 months. The forearm flap harvesting procedure was modified to incorporate STSG harvest directly from the flap skin paddle. RESULTS: There were 66 patients in this cohort, with mean age of 62.6 years. There were 58 fasciocutaneous radial forearm free flaps (RFFFs), three osteocutaneous RFFF, three ulnar flaps, and two reverse-flow RFFFs. The majority of flaps were used for mucosal coverage (n = 54), but 12 flaps were used for external skin coverage. The mean forearm defect was 36.5 cm2 (12–77 cm2). Harvesting from the forearm skin paddle was successful in 64 patients (97%). Two patients required a thigh STSG; both patients were octogenarians with frail skin. CONCLUSION: A thigh STSG donor site, with its associated morbidities, can be eliminated in 97 percent of patients undergoing forearm flaps. Older patients with frail skin may require a thigh donor site.

Novel STSG Donor Site for Forearm Flaps: Radial Skin Paddle

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P31-P31
Author(s):  
Tamer Abdel-Halim Ghanem ◽  
Mark K Wax
Keyword(s):  
Free Flap ◽  
Medical Center ◽  
Donor Site ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Patch Repair ◽  
Skin Grafts ◽  
Skin Paddle ◽  
Forearm Skin ◽  
Radial Forearm

Objective Split thickness skin grafts (STSG) harvested from the thigh are often utilized to provide coverage for radial forearm donor sites. To eliminate the morbidity of the thigh STSG donor site, we assessed the feasibility of harvesting the STSG from the radial. Methods Prospective data was collected from patients undergoing forearm free flap reconstruction at a tertiary medical center in a 6-month period. The radial forearm free flap (RFFF) harvesting procedure was modified to incorporate STSG harvest from the paddle site as the first step after arm tourniquet activation. Results There were 27 patients in this cohort, with mean age of 68.2. There were 24 fasciocutaneous RFFF, 2 osteocutaneous RFFF, and 1 ulnar flap. The indications for free tissue transfer were as follows: intraoral defects (n=13), pharyngeal patch repair (n=8), total laryngopharyngectomy (n=1), external skin coverage (n=5). The mean forearm defect was 41.2 cm2 (24–77 cm2). 22 out of 27 skin grafts were non-meshed. Harvesting from the forearm skin paddle was successful in 25 patients (93%). Two patients required a thigh STSG; both patients were octagenerians with frail skin. All the forearm donor sites healed well, except one patient required a later revision procedure for exposed tendon. Conclusions Based on this study, the thigh STSG donor site can be eliminated in 9 out of 10 patients undergoing radial forearm free flaps. This translates to decreased risk of pain, infection, and wound oozing. Older patients with frail skin and atrophied forearm muscles were likely to require a thigh donor site.

scholarly journals Experiência de um hospital de referência com o retalho livre anterolateral da coxa na reconstrução de extremidades

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Nikolas Higa Benites ◽  
Guilherme Leipner Margatho ◽  
Fernanda Ruiz de Andrade ◽  
Luis Guilherme Rosifini Alves Rezende ◽  
Amanda Favaro Cagnolati ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Donor Site ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Reconstruction ◽  
Anterolateral Thigh ◽  
Anterolateral Thigh Flaps ◽  
The Impact

Introdução: Com a evolução da microcirurgia ao longo dos anos o Retalho Anterolateral da Coxa vem se tornando uma das principais opções para reconstruções na cabeça, pescoço, tronco e extremidades devido sua versatilidade e confiabilidade. Objetivo: Descrever dados de um hospital terciário referência em trauma na reconstrução de extremidades com o Retalho Anterolateral da Coxa. Método: Este é um estudo retrospectivo de 18 retalhos Anterolateral da Coxa microcirúrgicos realizados entre Março de 2016 e Outubro de 2019 em pacientes de todas as idades, na reconstrução de membros, onde se observou dados referentes ao paciente: idade, sexo, membro acometido, tempo entre a lesão e a confecção do retalho; ao intraoperatório: anatomia dos vasos perfurantes, tempo cirúrgico total, vasos receptores utilizados; e informações do pós-operatório: número de cirurgias relacionadas ao retalho, necessidade de reabordagem e número de perdas. Foram excluídos pacientes que perderam seguimento ou que apresentaram dados do prontuário incompletos. Realizou-se estatística descritiva e cruzamento de algumas variáveis utilizando o teste t-Student. Resultados: Nas reconstruções houve predomínio de pacientes do sexo masculino (72%), em idade produtiva, de etiologia traumática e nos membros inferiores. O tempo médio até a reconstrução foi de 21 dias e o tempo cirúrgico foi de 384 minutos. O paciente permaneceu, em média, 39 dias internado. Dos 18 retalhos, 3 evoluíram com necrose, 2 por trombose arterial e 1 por infecção. 6 retalhos necessitaram de reaborgadem de emergência, 3 por sangramento, 2 por congestão e 1 por infecção. Foram realizadas uma média de 3 cirurgias até a alta. Foram identificadas 15 perfurantes miocutâneas (83%) e 3 septocutâneas (17%). A análise do sucesso do retalho em relação ao tempo cirúrgico e dos dias até a cirurgia não mostrou significância estatística, assim como a necessidade de reabordagem em relação ao tempo cirúrgico. Conclusão: O retalho Anterolateral da Coxa mostrou-se confiável, além de apresentar diversas vantagens como: por ser retirado com uma grande ilha de pele, apresentar pedículo longo, vasos de bom calibre, não necessitar de mudança de decúbito e apresentar baixa morbidade da área doadora.Descritores: Retalho Miocutâneo; Microcirurgia; Hospitais Especializados.ReferênciasDaniel RK, Taylor GI. Distant transfer of an island flap by microvascular anastomoses. A clinical technique. Plast Reconstr Surg. 1973;52(2):111-17.Ninkovic M, Voigt S, Dornseifer U, Lorenz S, Ninkovic M. Microsurgical advances in extremity salvage. Clin Plast Surg. 2012;39(4):491-505.Tamimy MS, Rashid M, Ehtesham-ul-Haq, Aman S, Aslam A, Ahmed RS. Has the anterolateral thigh flap replaced the latissimus dorsi flap as the workhorse for lower limb reconstructions? J Pak Med Assoc. 2010; 60(2):76-81.Spyropoulou A, Jeng SF. Microsurgical coverage reconstruction in upper and lower extremities. Semin Plast Surg. 2010;24(1):34-42.Xiong L, Gazyakan E, Kremer T, Hernekamp FJ, Harhaus L, Saint-Cyr M et al. Free flaps for reconstruction of soft tissue defects in lower extremity: a meta-analysis on microsurgical outcome and safety. Microsurgery. 2016; 36(6):511-24.Song YG, Chen GZ, Song YL. The free thigh flap: a new free flap concepted based on the septocutaneous artery. Br J Plast Surg. 1984; 37(2):149-59.Wei FC, Jain V, Celik N, Chen HC, Chuang DC, Lin CH. Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg. 2002;109(7):2219-26Kimata Y, Uchiyama K, Ebihara S, Nakatsuka T, Harii K. Anatomic variation and technical problems of the anterolateral thigh flap: A report of 74 cases. Plast Reconstr Surg. 1998; 102(5):1517-23Spindler N, Al-Benna S, Ring A, Homann H, Steinsträsser L, Steinau HU et al. Free anterolateral thigh flaps for upper extremity soft tissue reconstruction. GMS Interdiscip Plast Reconstr Surg DGPW. 2015;4:Doc05.Kimura N, Satoh K, Hasumi T, Ostuka T. Clinical application of the free thin anterolateral thigh flap in 31 consecutive patients. Plast Reconstr Surg. 2001;108(5):1197-210.Collins J, Ayeni O, Thoma A. A systematic review of anterolateral thigh flap donor site morbidity. Can J Plast Surg. 2012;20(1):17-23.Kuo YR, Jeng SF, Kuo MH, Huang MN, Liu YT, Chiang YC et al. Free anterolateral thigh flap for extremity reconstruction: Clinical experience and functional assessment of donor site. Plast Reconstr Surg. 2001;107(7):1766-71Novak CB, Lipa JE, Noria S, Allison K, Neligan PC, Gilbert RW. Comparison of anterolateral thigh and radial forearm free flap donor site morbidity. Microsurgery. 2007;27(8):651-54.Pagano M, Gauvreau K. Princípios de Bioestatística. São Paulo: Pioneira Thomson Learning; 2004.SAS Institute Inc., SAS/STAT® User’s Guide. Version 9.4. Cary, NC: SAS Institute Inc.Arruda LRP, Silva MAC, Malerba FG, Turíbio FM, Fernandes MC, Matsumoto MH. Fraturas expostas: estudo epidemiológico e prospectivo. Acta ortop bras. 2009;17(6):326-30.Cunha FM, Braga GF, Drumond Jr SN, Figueiredo CTO. Epidemiologia de 1.212 fraturas expostas. Rev Bras Ortop. 1998;33(6):451-56.Court-Brown CM, Rimmer S, Prakash U, McQueen MM. The epidemiology of open long bone fractures. Injury. 1998;29(7):529-34.Shabtai M, Rosin D, Zmora O, Munz Y, Scarlat A, Shabtai EL et al. The impact of a resident’s seniority on operative time and length of hospital stay for laparoscopic appendectomy: outcomes used to measure the resident’s laparoscopic skills. Surg Endosc. 2004;18(9):1328-30.Godina M. Early microsurgical reconstruction of complex trauma of the extremities. Plast Reconstr Surg.1986;78:285-292Smit JM, Acosta R, Zeebregts CJ, Liss AG, Anniko M, Hartman EH. Early reintervention of compromised free flaps improves success rate. Microsurgery. 2007;27(7):612-16.

scholarly journals Dermal Fillers for Facial Soft Tissue Augmentation

2007 ◽  
Vol 33 (4) ◽  
pp. 191-204 ◽  
Author(s):  
Sarosh F. Dastoor ◽  
Carl E. Misch ◽  
Hom-Lay Wang
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Augmentation ◽  
Dermal Fillers ◽  
Facial Soft Tissue ◽  
Tissue Augmentation

LONG-TERM DONOR-SITE MORBIDITY IN COMPOSITE ANTEROLATERAL THIGH FREE FLAP FOR COMPLEX DEFECT OF LOWER LEG AND FOOT RECONSTRUCTION

2020 ◽  
pp. 85-91
Author(s):  
Phuc Le Hong ◽  
Son Tran Thiet ◽  
Thuy Nguyen Xuan
Keyword(s):  
Soft Tissue ◽  
Skin Graft ◽  
Free Flap ◽  
Donor Site ◽  
Lower Extremities ◽  
Lower Leg ◽  
Donor Site Morbidity ◽  
Thigh Circumference ◽  
Anterolateral Thigh

Background: In recent years, the composite anterolateral thigh free flap with tensor fasciae latae or vastus lateralis has been a new-applied type of flap that can provide very good reconstruction materials in complex defects of lower leg and foot. The study purpose is to evaluate the systematically complications of donor site, related factors to results of the donor area, in order to apply the result to improve the treatment, which have not been much reported in literature. Materials and Methods: Systematic donor site morbilidy evaluation in a prospective, uncontrolled clinical descriptive study of 33 composite anterolateral thigh free flaps in various forms to reconstruct anatomical structures or to resconstruct deep defects combined with covering the surfaces for complex soft tissue defects in lower extremities for 32 patients due to different causes in lower leg and foot area from 2014-2019 at Hue University of Medicine and Pharmacy. Examining and evaluating aesthetic and functional result of donor-site 3 months and 6 months up to 2 year after surgery; evaluating the correlation between the width and the type of the flaps and donor site closure methods. Result: In 33 composite flaps used, flap width to thigh circumference less than 20% in 27 cases (81.8%), more than 20% in 6 cases (18.20% ); There were 28 cases in which the donor site was directly closed, 5 cases required skin graft; All direct closed cases had flap width/ thigh circumference index below 20%; On the contrary, in cases having this index greater than 20%, the donor site required skin graft with p < 0.01. There are 11/33 (33.33%) of cases reported complications in donor site ; lateral thigh paresthesia is the most complicated complication with 8/33 cases (24.24%), followed by bad scarring 3/33 cases (9.09%). Conclusion: Long term follow up donor site morbility after composite anterior thigh free flap present 11/33 cases (33.33%): mostly complications of the donor site are thigh paresthesia with 8/33 cases (24.24%), and bad scarring 3/33 cases (9,09%), which improve time by time. Keywords: Composite anterior thigh free flap, lower extremities soft tissue defect, donor site morbidity

scholarly journals Results of Microvascular Free Flap for Reconstruction of Soft Tissue Defects: Our Early Experience

2014 ◽  
Vol 3 (2) ◽  
pp. 33-37
Author(s):  
Debashis Biswas ◽  
Md Abul Kalam ◽  
Tanveer Ahmed ◽  
Md Rabiul Karim Khan
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Free Flaps ◽  
Soft Tissue Defect ◽  
Soft Tissue Defects ◽  
Tissue Defect ◽  
Radial Forearm ◽  
After Cancer ◽  
Microvascular Free Flap ◽  
Tissue Defects

Extensive soft tissue defects following trauma, burn or after cancer surgery need coverage by flaps. Sometimes surrounding tissues are not healthy enough or quantity is not favorable to provide adequate pedicle flaps. Microvascular free flap can provide healthy tissue of adequate amount from distant area for those difficult situations.15 microvascular free flaps were performed from October 2011 to February 2013. Radial forearm free flap was done in 8 and Latissimusdorsi (LD) flap in 7 cases. 10 flaps done in foot, ankle & lower leg region (radial forearm-5, LD-5) and 5 flaps were done in face and scalp region (radial forearm-4, LD-1).12 flaps healed uneventfully with good coverage of the defect. Average ischemia time was 135 min (range 100-240 min) and average anastomosis time was 75 min (average 60-100 min). 2 flaps failed. There was necrosis of the tip of 2 LD and cumbersome swelling of the flap was found in 2 cases of LD flaps.Large soft tissue defect of body where local or regional flaps are not feasible; can be easily covered with free flaps. Its capacity to cover huge soft tissue defect has neutralizes its technical demand. Though complications are still high in our hands; can be reduced performing more number of cases. DOI: http://dx.doi.org/10.3329/bdjps.v3i2.18242 Bangladesh Journal of Plastic Surgery July 2012, 3(2): 33-37

scholarly journals Free flaps in Surgical Dermatology: comparison between fasciocutaneous and myocutaneous free flaps in facial reconstructions

2011 ◽  
Vol 86 (6) ◽  
pp. 1145-1150
Author(s):  
Francisco Miguel Camacho-Martínez ◽  
Angel Rollón ◽  
Clara Salazar ◽  
Elena M Rodríguez-Rey ◽  
David Moreno
Keyword(s):  
Free Flap ◽  
Malignant Tumors ◽  
Donor Site ◽  
Free Flaps ◽  
Single Step ◽  
Rectus Abdominis ◽  
Original Position ◽  
Random Pattern ◽  
Recipient Site ◽  
Palmar Surface

BACKGROUND: Dermatologic surgeons routinely harvest pedicled flaps at distance with an axial or random pattern to repair facial defects. These types of skin flaps are time-consuming and have high economic, social and personal costs. These drawbacks could be avoided with the introduction of a single-step transfer of free flaps to the recipient site, with microvascular anastomosis. OBJECTIVE: To demonstrate that better results are obtained with myocutaneous or fasciocutaneous free flaps and which one is more suitable in surgical dermatology. MATERIAL AND METHODS: We selected two patients of opposite sexes and similar ages who had undergone Mohs surgery to remove recurrent malignant tumors that were located in the upper cheek bordering the zygomatic zone. The woman was treated with a fasciocutaneous radial free flap and the man with a rectus abdominis free flap. RESULTS: Both patients had excellent immediate postoperative outcomes. Complications observed in the male patient were related to a previous pulmonary alteration. The fasciocutaneous radial free flap reconstruction was easier to perform than the rectus abdominis free flap; nevertheless, the radial free flap is very thin and, although the palmaris longus tendon is used, it does not yield enough volume, requiring later use of implants. In contrast, the rectus abdominis free flap transfers a wide flap with enough fat tissue to expand in the future. As for the cosmetic results regarding the donor site, the rectus abdominis free flap produces better-looking scars, since secondary defects of the palmar surface cannot be directly closed and usually require grafting - a situation that some patients do not accept. CONCLUSIONS: In surgical dermatology, each case, once the tumor has been extirpated, requires its own reconstructive technique. The radial free flap is suitable for thin patients who are willing to cover their arm with a shirt. The rectus abdominis free flap is best suited for obese patients with deep and voluminous defects, although it is necessary to dislocate the navel from its original position

Reconstruction of Large Palmar Defects of the Hand Using Free Flaps

1997 ◽  
Vol 22 (5) ◽  
pp. 623-630 ◽  
Author(s):  
M. M. NINKOVÍC ◽  
A. H. SCHWABEGGER ◽  
G. WECHSELBERGER ◽  
H. ANDERL
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Subcutaneous Tissue ◽  
Free Flaps ◽  
Difficult Problem ◽  
Glabrous Skin ◽  
Soft Tissue Reconstruction ◽  
Anatomical Structures ◽  
Tissue Reconstruction ◽  
Restoration Of Sensibility

The reconstruction of large palmar defects of the hand remains a difficult problem due to the specific anatomical structures and highly sophisticated function of the palm. The glabrous skin and subcutaneous tissue in the palm are perfectly adapted to serve the prehensile function. The particular aim must be that repairs to this functional structure are similar in texture and colour and are aesthetically acceptable. Restoration of sensibility is desirable. For smaller defects a great variety of local pedicled or island flaps can be applied. However, for larger defects with exposed tendons, nerves or other essential structures, free flaps remain as a reliable alternative. This paper reviews our approach of soft tissue reconstruction in 16 patients with large palmar defects using various kinds of free flaps. The advantages, disadvantages and current indications for free flap resurfacing of the palm are discussed.

scholarly journals Sequela de cirurgia para reconstrução mandibular após ressecção de ameloblastoma

2019 ◽  
Vol 8 (8) ◽  
Author(s):  
Allancardi dos Santos Siqueira ◽  
Luiz Henrique Soares Torres ◽  
Jiordanne Araújo Diniz ◽  
Éwerton Daniel Rocha Rodrigues ◽  
Caio Pimenteira Uchôa ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Platelet Rich Plasma ◽  
Treatment Algorithm ◽  
Free Flaps ◽  
Mandibular Reconstruction ◽  
Benign Tumors ◽  
New Classification ◽  
Oromandibular Reconstruction ◽  
Head Neck

Os defeitos mandibulares devido à ressecção de lesão óssea interferem a harmonia e estética facial comprometendo a qualidade de vida dos pacientes. Grandes defeitos exigem planejamento minucioso, principalmente quando lançamos mão de enxertos e placas de reconstrução, evitando assim resultados insatisfatórios ou até mesmo sequelas. Apesar de algumas classificações dos defeitos mandibulares vêm sendo discutidas ao longo dos anos, ainda não há um protocolo definido para reconstrução mandibular. O uso de prototipagem na Cirurgia Bucomaxilofacial tem se tornado cada vez mais frequente; a precisão da reconstrução, diminuição do tempo de cirurgia reflete em recuperação mais rápida do paciente. Mesmo com a ferramenta da prototipagem, grandes lesões e perdas ósseas permanecem como grande desafio ao cirurgião.  O objetivo deste trabalho é relatar um caso clínico de reconstrução mandibular no qual houve a necessidade de ser tratado com remoção de placa de reconstrução e nova reabilitação cirúrgica do paciente.Descritores: Mandíbula; Reconstrução Mandibular; Modelos Biológicos.ReferênciasSantos LCS, Seixas AM, Barbosa B, Cincura RNS. Adaptação de placas reconstrutivas: uma nova técnica. Rev Cir Traumatol Buco-Maxilo-Fac. 2011;11(2):9-14.Lin PY, Lin KC, Jeng SF. Oromandibular reconstruction: the history, operative options and strategies, and our experience. ISRN Surg. 2011;2011:824251.Martins Jr. JC, Keim FS. Uso de prototipagem no planejamento de reconstrução microcirúrgica da mandíbula. Rev Bras Cir Craniomaxilofac. 2011;14(4):225-28.Montoro JR, Tavares MG, Melo DH, Franco Rde L, Mello-Filho FV, Xavier SP, Trivellato AE, Lucas AS. Mandibular ameloblastoma treated by bone resection and imediate reconstruction. Braz J Otorhinolaryngol. 2008;74(1):155-57.Nóia CF, Ortega-Lopes R, Chaves Netto HDM, Nascimento FFAO, Sá BCM. Desafios na reconstrução mandibular devido a lesões extensas ou traumatismos. Rev Assoc Paul Cir Dent. 2015;69(2):158-63.Cohen A, Laviv A, Berman P, Nashef R, Abu-Tair J. Mandibular reconstruction using stereolithographic 3-dimensional printing modeling technology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(5):661-6.Rana M, Warraich R, Kokemüller H,  Lemound J,  Essig H, Tavassol F et al. Reconstruction of mandibular defects - clinical retrospective research over a 10-year period. Head Neck Oncol. 2011;3:23.Fariña R, Alister JP, Uribe F, Olate S, Arriagada A. Indications of Free Grafts in Mandibular Reconstruction, after Removing Benign Tumors: Treatment Algorithm. Plast Reconstr Surg Glob Open. 2016;4(8):e845.Fariña R, Plaza C, Martinovic G. New transference technique of position of mandibular reconstructing plates using stereolithographic models. J Oral Maxillofac Surg. 2009;7(11):2544-48.Mooren RE, Merkx MA, Kessler PA, Jansen JA, Stoelinga PJ. Reconstruction of the mandible using preshaped 2.3-mm titanium plates, autogenous cortical bone plates, particulate cancellous bone, and platelet-rich plasma: a retrospective analysis of 20 patients. J Oral Maxillofac Surg. 2010;68(10):2459–67.Brown JS, Barry C, Ho M, Shaw R.A new classification for mandibular defects after oncological resection. Lancet Oncol. 2016;17(1):23-30Urken ML, Weinberg H, Vickery C, Buchbinder D, Lawson W, Biller HF. Oromandibular reconstruction using microvascular composite free flaps. Report of 71 cases and a new classification scheme for bony, soft-tissue, and neurologic defects. Arch Otolaryngol Head Neck Surg. 1991;117(7):733-44.Shnayder Y, Lin D, Desai SC, Nussenbaum B, Sand JP, Wax MK. Reconstruction of the Lateral Mandibular Defect: A Review and Treatment Algorithm. JAMA Facial Plast Surg. 2015;17(5):367-73.Wei FC, Celik N, YangWG, Chen IH, Chang YM, Chen HC. Complications after reconstruction by plate and soft-tissue free flap in composite mandibular defects and secondary salvage reconstruction with osteocutaneous flap. Plast Reconstr Surg. 2003;112(1):37-42.Li BH, Jung HJ, Choi SW, Kim SM, Kim MJ, Lee JH. Latissimus dorsi (LD) free flap and reconstruction plate used for extensive maxillo-mandibular reconstruction after tumour ablation. J Craniomaxillofac Surg. 2012;40(8):293-300.

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