Abstract
BackgroundA vascularized fibular osteomyocutaneous flap with severe vascular crisis often results in serious consequences. This study aims to examine the clinical effect of non-vascularized fibular graft on patients with severe vascular crisis after reconstruction of the defect jaw with vascularized fibular osteomyocutaneous flap.Materials and methodsFrom December 2007 to December 2018, a total of 104 patients with jaw neoplasms that underwent reconstruction with free vascularized fibular flap were retrospectively analyzed; seven of these cases had postoperative vascular crisis during mandibular reconstruction.ResultsOf the seven cases with postoperative vascular crisis, the vascularized fibular flaps in three patients survived completely, thanks to early detection; two cases were completely necrotic and removed in the end, and the remaining two cases had severe vascular crisis after the removal of the soft tissue attached to the fibular flap. The non-vascular fibular grafts were retained regardless of the severe absorption after follow-ups for 25 and 69 months, respectively.ConclusionsIf vascular crisis occurs following jaw reconstruction with a vascularized fibular osteomyocutaneous flap, early re-surgical exploration effectively improves the salvage rate. In addition, when a severe vascular crisis occurs, the vascularized fibular flap can be changed to a non-vascular fibular graft to reconstruct the mandibular defect, thus avoiding the serious consequences resulting from the complete failure of fibular graft.
Highlights
Vascularized fibular osteomyocutaneous flap has been currently advocated in jaw reconstruction for large defects, which contributes to the restoration of the facial appearance and chewing function of the patient [1,2,3]
Vascular anastomosis is required in a free tissue flap; it is of great importance to detect vascular crisis in the anastomotic blood vessels at the early
Shao et al World Journal of Surgical Oncology (2020) 18:46 grafts. This remedial treatment contributed to achieving certain clinical effects
Summary
Vascularized fibular osteomyocutaneous flap has been currently advocated in jaw reconstruction for large defects, which contributes to the restoration of the facial appearance and chewing function of the patient [1,2,3]. Vascular anastomosis is required in a free tissue flap; it is of great importance to detect vascular crisis in the anastomotic blood vessels at the early. Shao et al World Journal of Surgical Oncology (2020) 18:46 grafts. As a result, this remedial treatment contributed to achieving certain clinical effects. A vascularized fibular osteomyocutaneous flap with severe vascular crisis often results in serious consequences. This study aims to examine the clinical effect of non-vascularized fibular graft on patients with severe vascular crisis after reconstruction of the defect jaw with vascularized fibular osteomyocutaneous flap
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