The free scapular flap with latissimus muscle reduces fistulas in mandibular reconstruction

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http://hdl.handle.net/10138/224056

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Wilkman , T , Tornwall , J , Vuola , J & Lassus , P 2016 , ' The free scapular flap with latissimus muscle reduces fistulas in mandibular reconstruction ' , Journal of Plastic, Reconstructive & Aesthetic Surgery , vol. 69 , no. 6 , pp. 802-808 . https://doi.org/10.1016/j.bjps.2016.03.007

Title: The free scapular flap with latissimus muscle reduces fistulas in mandibular reconstruction
Author: Wilkman, Tommy; Tornwall, Jyrki; Vuola, Jyrki; Lassus, Patrik
Contributor organization: Clinicum
Suu- ja leukakirurgian yksikkö
Department of Oral and Maxillofacial Diseases
Plastiikkakirurgian yksikkö
Date: 2016-06
Language: eng
Number of pages: 7
Belongs to series: Journal of Plastic, Reconstructive & Aesthetic Surgery
ISSN: 1748-6815
DOI: https://doi.org/10.1016/j.bjps.2016.03.007
URI: http://hdl.handle.net/10138/224056
Abstract: Introduction: The free scapular chimeric flap is a less common choice for facial reconstruction. This study aimed to evaluate the versatility and safety of the flap, the procedure for a two-team approach, the safety of the osteotomies, the possibility of dental implants and donor-site sequelae and complications. Patient and methods: We analysed 34 consecutive patients with oral cancer undergoing large resections in the maxillofacial region as well as scapular chimeric free flap reconstruction. We performed 26 mandibular, six maxillary and two orbital reconstructions using a two-team approach, mainly without repositioning the patient. Results: No flaps were lost. Three patients with a scapular bone and fasciocutaneous flap developed a post-operative fistula, whereas no fistulas developed when the flaps included a muscular component. All osteotomies showed confirmed osseal consolidation. Seven patients received a total of 23 dental implants for oral rehabilitation; no implants were lost. Conclusions: The scapular flap is reliable and contains sufficient bone to tolerate both multiple osteotomies and osseointegrated dental implants. The flap can be harvested in a slightly tilted decubital position, thus shortening the theatre time. The use of a separate muscle around the scapular bone in mandibular reconstruction is associated with a lower risk of oral fistulas. (C) 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Subject: Scapular free flap
Mandibular reconstruction
Complications
Fistula
Osteotomy
Dental implants
FIBULA FREE-FLAP
OROMANDIBULAR RECONSTRUCTION
MAXILLARY RECONSTRUCTION
NECK RECONSTRUCTION
HEAD
DEFECTS
SURGERY
COMPLICATIONS
ANATOMY
BONE
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion


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