Application of the posteromedial thigh flap for oral and maxillofacial defect reconstruction

Abstract

To explore the feasibility of using the posteromedial thigh flap as an alternative source for oral and maxillofacial reconstruction. During January 2019 to January 2020, twenty-three patients underwent oral and maxillofacial tumor ablation and defect reconstruction with 23 posteromedial thigh flaps were enrolled in the Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University. Thirteen of the patients were male and ten were female, with age of (54.5±9.7) years (33-72 years). The numbers and types of perforators, the dimension of flap and the vascular pedicle length were measured. The outcomes of flaps and donor-site complication were recorded. The patients' satisfaction with donor-site cosmesis were evaluated by the visual analogue scale (VAS). More than one sizable perforators was found in each case and the median number of perforators was 2 (range, 1 to 4), and all of the perforators were musculocutaneous. The pedicle length was (9.8±1.5) cm (range, 7.3 to 13.4 cm). The diameters of artery and the larger vein were 2.0 mm (range, 1.5 to 2.5 mm) and 2.0 mm (range, 1.5 to 3.0 mm), respectively. The dimension of the flaps ranged from 8 cm×6 cm to 12 cm×8 cm, and the donor sites were all closed primarily. All of the flaps were clinically survived, only one patient experienced partial wound dehiscence of donor site 14 days postoperatively and no donor site infection or permanent muscular weakness was reported. The VAS scores of the patients' satisfaction with donor-site cosmesis were all more than 8. The perforators of the posteromedial thigh flap is consistent and the donor-site scar is well concealed, which make the posteromedial thigh flap an excellent option for oral and maxillofacial reconstruction.