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Mandibular reconstruction with composite microvascular tissue transfer.

J J Coleman1, W A Wooden

  • 1Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.

American Journal of Surgery
|October 1, 1990
PubMed
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Microvascular free tissue transfer offers reliable mandibular reconstruction for defects from cancer or trauma. This technique restores bone and soft tissue, achieving good function and appearance despite prior treatments.

Area of Science:

  • Plastic Surgery
  • Oral and Maxillofacial Surgery
  • Oncology

Background:

  • Mandibular defects often result from tumor resection or trauma.
  • Reconstruction of these defects presents significant challenges.
  • Vascularized tissue transfer is a key reconstructive modality.

Purpose of the Study:

  • To evaluate the efficacy of microvascular free tissue transfer for mandibular reconstruction.
  • To assess outcomes in patients with defects from cancer, trauma, and other conditions.
  • To analyze complications and functional results of these reconstructions.

Main Methods:

  • A retrospective review of 26 patients undergoing 28 microvascular free flap reconstructions over 7 years.
  • Analysis of flap types (scapula, radial forearm, fibula, etc.) and defect locations.

Related Experiment Videos

  • Assessment of pre- and post-operative radiotherapy, and complication rates.
  • Main Results:

    • Successful vascularized reconstruction was achieved in all patients.
    • High rates of bony stability (25/26) and oral continence (24/26) were observed.
    • Complications occurred in 22 patients, including partial skin necrosis and fistulas.

    Conclusions:

    • Microvascular free tissue transfer is a reliable method for mandibular reconstruction, even in challenging cases with prior radiation or infection.
    • The technique facilitates bony union, wound healing, and functional recovery.
    • While complications can occur, they are manageable, and good functional and aesthetic outcomes are likely.