Single flap reconstruction for complex oro-facial defects using chimeric free fibular flap variants

Area of Science:

• Plastic Surgery
• Oral and Maxillofacial Surgery
• Microsurgery

Background:

• Reconstructing three-dimensional orofacial defects presents significant challenges.
• Traditional methods may involve multiple surgical stages and considerable donor-site morbidity.

Purpose of the Study:

• To evaluate the efficacy of chimeric free fibular flaps in orofacial reconstruction.
• To assess the versatility and outcomes of different chimeric fibular flap variants.

Main Methods:

• Retrospective review of 12 cases using chimeric free fibular flaps between 2009 and 2012.
• Utilized osseo-myo-cutaneous (OMC), multi-pedicled OMC (Mp-OMC), and multi-pedicled osseo-cutaneous (Mp-OC) variants.
• Applied flaps for post-excisional defects and osteoradionecrosis.

Main Results:

• Achieved 100% flap survival in all 12 cases.
• One case experienced partial flap loss due to the 'puppeteer' effect.
• Demonstrated successful reconstruction of complex spatial defects.

Conclusions:

• Chimeric free fibular flaps are a highly effective and versatile option for complex orofacial reconstruction.
• This technique minimizes donor-site morbidity and operating time.
• The chimeric fibular flap is a valuable addition to the reconstructive surgeon's armamentarium.