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Complex Orofacial Reconstruction with the Intrinsic Chimeric Flap.

Andrés A Maldonado1, Amanda K Silva1, Laura S Humphries1

  • 1Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago Medicine, Chicago, Illinois.

Journal of Reconstructive Microsurgery
|January 6, 2017
PubMed
Summary
This summary is machine-generated.

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Intrinsic chimeric free flaps offer a versatile solution for complex head and neck cancer reconstructions, simplifying procedures and improving outcomes. This study guides flap selection and identifies factors influencing success.

Area of Science:

  • Plastic Surgery
  • Head and Neck Surgery
  • Oncology

Background:

  • Ablation for head and neck cancer frequently creates extensive orofacial defects.
  • Limited recipient vessels complicate reconstruction of these defects.
  • Intrinsic chimeric flaps offer a versatile solution with single microvascular anastomosis.

Purpose of the Study:

  • To evaluate the efficacy of intrinsic chimeric free flaps for orofacial reconstruction.
  • To develop a guide for selecting intrinsic chimeric flaps based on defect characteristics.
  • To identify risk factors for flap complications.

Main Methods:

  • Retrospective review of 75 patients undergoing orofacial reconstruction with intrinsic chimeric free flaps (2002-2015).
  • Exclusion of flaps with a single tissue type.

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  • Analysis of patient demographics, defect/flap characteristics, complications, and outcomes.
  • Univariate and multivariate analysis for risk factors of flap take-back and failure.

    • Main Results:

    • Seventy-five intrinsic chimeric free flap reconstructions were analyzed.
    • A guide for flap selection was developed based on defect characteristics.
    • Increased flap components and operative duration correlated with flap take-backs (p<0.05).
    • Total flap loss rate was 3%, and partial flap loss was 7%.

    Conclusions:

    • Intrinsic chimeric flaps are a versatile reconstructive option for complex orofacial defects.
    • The study provides a decision-making guide for flap selection.
    • Factors associated with flap take-backs and losses were identified.