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Prevention points for plate exposure in the mandibular reconstruction
Satoshi Onoda1, Yoshihiro Kimata, Kiyoshi Yamada
1Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Science, University of Okayama, 700-8558 Okayama, Japan. satoshiprs18@gmail.com
Summary
Reconstruction plates offer a viable option for mandibular reconstruction, with a low complication rate. Factors beyond flap choice influence plate exposure, suggesting careful surgical technique is key.
Area of Science:
- Oral and Maxillofacial Surgery
- Reconstructive Surgery
Background:
- Mandibular reconstruction following segmental mandibulectomy often involves reconstructive plates or vascularized bone grafts.
- Reconstructive plates historically have a higher complication rate compared to vascularized bone grafts.
Observation:
- This study reviewed 17 cases of mandibular reconstruction using reconstructive plates with implemented prevention methods.
- Various flap types were utilized, including rectus abdominis myocutaneous, anterolateral thigh with vastus lateralis muscle, and omentum.
- Two cases did not involve flap transfer.
Findings:
- Plate exposure occurred in only one out of 17 cases within 3 months postoperatively.
- The single case of plate exposure was in a patient without flap transfer, suggesting dead space as a contributing factor.
- The majority of cases (16/17) showed no plate exposure during the follow-up period.
Implications:
- Reconstructive plate use is a valuable technique in mandibular reconstruction, particularly for patients unsuitable for vascularized bone grafts.
- Factors beyond flap selection, such as managing dead space, are critical in preventing reconstructive plate exposure.
- Further research into optimizing reconstructive plate techniques is warranted to minimize complications.
