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Calf Perforator Flaps: A Freestyle Solution for Oral Cavity Reconstruction
Alexandra R Molina1,2, Isabelle Citron1,2, Fungayi Chinaka1,2
1London, United Kingdom.
Plastic and Reconstructive Surgery
|January 27, 2017
Summary
Calf perforator flaps offer a thinner, pliable alternative for oral cavity reconstruction compared to traditional thigh flaps. This study highlights their suitability, demonstrating reduced tissue thickness and successful clinical application with minimal donor site issues.
Area of Science:
- Plastic Surgery
- Oral and Maxillofacial Surgery
- Reconstructive Surgery
Background:
- Oral cavity defect reconstruction necessitates thin, pliable flaps for optimal functional outcomes.
- Traditional flap options like anterolateral thigh flaps are often too thick, and radial forearm flaps have poor donor sites.
- Calf perforator flaps, particularly the medial sural artery perforator flap, offer a promising alternative with thin tissue and acceptable donor sites.
Purpose of the Study:
- To evaluate the suitability of calf perforator flaps for intraoral reconstruction.
- To compare the tissue thickness of calf and thigh regions.
- To assess the clinical outcomes of using calf perforator flaps in oral cavity reconstruction.
Main Methods:
- Radiologic analysis: Computed tomographic scans of 100 lower limbs compared thigh and calf tissue thickness.
- Clinical study: Prospective data collection from 20 patients undergoing oral cavity reconstruction with calf perforator flaps.
Main Results:
- Calf tissue envelope was significantly thinner (mean 8.4 mm) than thigh tissue (mean 17 mm) on CT scans.
- Medial sural artery perforator flaps were used in 17 of 20 cases.
- Mean pedicle length was 10.2 cm, mean flap elevation time was 85 minutes, with no flap losses and one case of late hematoma/wound dehiscence.
Conclusions:
- Calf perforator flaps provide ideal, thin tissue for intraoral reconstruction, superior to anterolateral thigh flaps.
- Medial sural artery perforator flaps, along with other calf perforator variations, are effective.
- The calf donor site offers minimal morbidity for harvesting thin, pliable tissue.
