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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
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Risk factors assessment in fibular free flap mandibular reconstruction
C Bouland1, N Albert1, E Boutremans1
1Department of Stomatology-Maxillofacial surgery, CHU Saint Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Annales De Chirurgie Plastique Et Esthetique
|April 3, 2021
Summary
Fibular free flap (FFF) mandibular reconstruction has a high success rate. This study identified risk factors for complications, including previous neck dissection, radiotherapy, operative time, and ischemia time, to improve outcomes.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic Surgery
- Reconstructive Surgery
Background:
- Fibular free flap (FFF) is the preferred method for mandibular reconstruction.
- Risk factors for FFF failure and complications require further identification to enhance success rates.
Purpose of the Study:
- To analyze risk factors associated with fibular free flap (FFF) mandibular reconstruction failures and complications.
- To improve the overall success rate of FFF in mandibular reconstruction.
Main Methods:
- Retrospective study of patients undergoing FFF mandibular reconstruction from January 2014 to December 2018.
- Analysis of patient demographics, comorbidities, operative details, and complication rates at recipient and donor sites.
Main Results:
- Overall success rate of 90% in 30 patients.
- Identified risk factors for recipient site infections (atherosclerosis, operative time), dehiscence (previous cervical dissection, secondary reconstruction), and flap necrosis (ischemia time, NNISS score, alcohol consumption, radiotherapy).
- Donor site morbidities were associated with NNISS and early dehiscence rates.
Conclusions:
- FFF mandibular reconstruction demonstrates a high success rate.
- Previous neck dissection, radiotherapy, operative time, and ischemia time are significant risk factors for recipient site complications.
- NNISS score and dehiscence rate are risk factors for FFF necrosis.
