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Reduction of ischemic time using the pull-through technique for scapular free flap.
Yoshio Ohyama1, Kazuki Hasegawa2, Narikazu Uzawa3
1Department of Oral and Maxillofacial Surgery, Shizuoka City Shizuoka Hospital, 10-93, Outemachi, Aoi-ku, Shizuoka-shi, Shizuoka, 420-8690, Japan. yohyama1219@gmail.com.
Oral and Maxillofacial Surgery
|January 9, 2025
Summary
The pull-through technique (PTT) for scapular free flap (SFF) harvest significantly reduces ischemic time in mandibular reconstruction compared to traditional methods. This PTT-SFF approach improves flap viability and simplifies the surgical procedure.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic and Reconstructive Surgery
- Microsurgery
Background:
- Mandibular reconstruction using scapular free flaps (SFF) traditionally requires patient repositioning.
- Repositioning can hinder simultaneous resection and harvest, potentially increasing flap ischemic time.
Purpose of the Study:
- To evaluate the efficacy of the pull-through technique (PTT) for SFF harvest.
- To determine if PTT reduces ischemic time during mandibular segmental resection.
Main Methods:
- Retrospective analysis of 24 patients undergoing SFF mandibular reconstruction (2015-2022).
- Comparison between 13 patients receiving PTT-SFF and 11 patients receiving non-PTT SFF.
- Analysis of demographic data, operative time, and ischemic time.
Main Results:
- No significant differences in age, sex, diagnosis, or resected segments between groups.
- Significantly shorter ischemic time in the PTT group compared to the non-PTT group.
- PTT allowed for minimal intraoperative position changes.
Conclusions:
- The pull-through technique (PTT) for SFF harvest significantly reduces ischemic time in mandibular reconstruction.
- PTT facilitates stable blood flow visualization, potentially enhancing flap viability.
- PTT offers an advantage for simultaneous resection and harvest, improving surgical efficiency.
