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Managing Oromandibular Hardware Failure after Free Flap Surgery.

Aaron M Domack1, Dustin A Silverman1, Alice L Tang1

  • 1Department of Otolaryngology, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Seminars in Plastic Surgery
|February 13, 2023
PubMed
Summary

Hardware failure in oromandibular reconstruction can impede cancer treatment and oral function. Strict adherence to rigid fixation principles and early intervention for hardware exposure are crucial for preventing complications and avoiding extensive revision surgery.

Keywords:
free flapfree tissue transferhardware failuresurgical complications

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Reconstructive Surgery
  • Biomaterials in Medicine

Background:

  • Hardware failure following oromandibular reconstruction using free tissue transfer presents a significant challenge.
  • Complications can delay essential cancer therapies and hinder the restoration of normal oral function.
  • Ensuring the stability of reconstruction is paramount for patient recovery and oncologic outcomes.

Purpose of the Study:

  • To highlight the critical role of rigid fixation in preventing hardware failure after oromandibular reconstruction.
  • To emphasize the importance of timely surgical intervention for hardware exposure.
  • To discuss the utility of locoregional flaps in managing complications and potentially avoiding complex revisions.

Main Methods:

  • Review of clinical cases involving hardware complications after free tissue transfer for oromandibular reconstruction.
  • Analysis of surgical techniques focusing on rigid fixation principles.
  • Evaluation of outcomes associated with early intervention for hardware exposure and use of locoregional flaps.

Main Results:

  • Hardware failure can lead to delayed adjuvant therapies and impaired oral function.
  • Adherence to rigid fixation principles is strongly associated with reduced complication rates.
  • Early surgical management of hardware exposure and the use of locoregional flaps can effectively address complications.

Conclusions:

  • Strict adherence to rigid fixation is essential for successful oromandibular reconstruction.
  • Prompt surgical intervention for hardware exposure and consideration of locoregional flaps are key strategies to mitigate complications and improve patient outcomes.
  • Preventing hardware failure is critical for enabling timely cancer treatment and restoring oral function.