Chimeric deep circumflex iliac artery perforator flap for the simultaneous reconstruction of the composite oromandi-bular defect
10.7518/hxkq.2015.03.013
- VernacularTitle:旋髂深动脉穿支嵌合髂骨皮瓣修复下颌骨复合性缺损
- Author:
Jie CHEN
1
;
Canhua JIANG
;
Anjie MIN
;
Hui REN
;
Zhengyang GAO
;
Xinchun JIAN
Author Information
1. 中南大学湘雅医院口腔颌面外科
- Keywords:
deep circumflex iliac artery;
chimeric perforator flap;
mandibular defect;
reconstruction
- From:
West China Journal of Stomatology
2015;(3):276-280
- CountryChina
- Language:Chinese
-
Abstract:
Objective??To?evaluate?the?feasibility?and?outcomes?of?chimeric?deep?circumflex?iliac?artery?perforator?flap?(DCIAPF)?applied?in?the?simultaneous?reconstruction?of?the?oromandibular?defect. Methods??Six?patients?underwent?simul-taneous?oromandibular?reconstruction?using?DCIAPF?following?segmental?mandibulectomy?in?Xiangya?Hospital?from?March?2014?to?July?2014.?The?skin?paddle?was?designed?to?be?centered?on?the?pre-operative?perforator?mapping.?Retrograde?dissection?was?performed?through?the?underlying?abdominal?wall?to?raise?the?skin?paddle.?The?pedicle?was?isolated?from?the?groin,?and?the?iliac?crest?was?cut.?The?deep?iliac?circumflex?vessels?were?dissected?until?the?skin?paddle?was?reached.?Finally,?the?donor?site?was?strictly?sutured?layer?by?layer?to?avoid?ventral?hernia.?Results??The?skin?paddles?ranged?from?3.5?cm×5.0?cm?to?7.0?cm× 10.0?cm.?The?length?of?the?bone?components?was?5.0?cm?to?11.0?cm.?All?donor?sites?closed?primarily?without?skin?grafting.?DCIAPF?was?harvested?successfully?in?five?patients,?except?for?one?patient?whose?perforator?originated?from?the?superficial?iliac?circumflex?vessels.?An?additional?pair?of?anastomoses?was?performed.?All?iliac?flaps?survived.?However,?slight?skin-edge?necrosis?and?exfoliation?caused?by?flap?thinning?occurred?in?one?patient?and?healed?after?pruning?and?dressing?change.?The?heights?of?all?alveolar?ridges?were?significantly?restored,?and?no?serious?donorsite?complication?was?observed?during?the?three?to?six?months’?follow-up.?Conclusion??DCIAPF?is?a?reconstructive?option?for?mandibular?defects?because?of?its?adequate?bone?tissue?and?rich?blood?supply.?Satisfactory?alveolar?ridge?restoration?greatly?facilitates?future?denture?retention.?DCIAPF?also?has?a?great?degree?of?mobility?between?the?skin?paddle?and?the?bone?component?when?applied?in?composite?oromandibular?defect?reconstruction.
