"Naked microvascular bone flap" in oral reconstruction

Area of Science:

• Oral and Maxillofacial Surgery
• Reconstructive Surgery
• Biomaterials Science

Background:

• Bone free flaps have been utilized for maxilla and mandible reconstruction since the 1980s.
• Vascular pedicles ensure flap vitality, bone integration, and reduce infection risk.
• Surgeons often protect bone flaps due to concerns about orocervical/orosinusal fistulas and infections.

Purpose of the Study:

• To evaluate the efficacy and complication rates of "naked" bone free flaps versus traditional "covered" bone free flaps in oral cavity reconstructions.
• To challenge the conventional practice of burying bone flaps due to perceived risks of infection and fistulas.

Main Methods:

• Retrospective review of oral cavity reconstructions using naked and covered bone free flaps.
• Naked bone flaps were defined as bone flaps covered only by a 5-20 mm muscle layer.
• Evaluation of early and late major and minor complications associated with each technique.

Main Results:

• The study retrospectively analyzed complications associated with both naked and covered bone free flap techniques.
• Findings aimed to demonstrate the viability and safety of naked bone flaps in oral reconstructions.
• Complication data (major/minor, early/late) were compared between the two reconstructive approaches.

Conclusions:

• Well-vascularized naked bone free flaps can independently heal and repair osteomucosal deficits.
• The use of naked bone flaps can mitigate risks of infection and fistulas in oral reconstructions.
• This study provides evidence supporting the use of naked bone free flaps as a safe and effective reconstructive option.