Soft tissue flaps in facial reconstruction

Abstract

The oral and maxillofacial surgeon has been, traditionally, the leading professional in the area of treatment of facial trauma, especially in reconstruction of the facial skeleton and the rehabilitation of the resulting functional disabilities. However, the aspect of soft tissue reconstruction by the use of pedicled local and regional flaps has been relatively neglected in the overall scope of our specialty. Considering the experience and understanding by the oral and maxillofacial surgeons of the functional characteristics of the different tissues in the facial area, a comprehensive approach to soft tissue reconstruction was considered by the presenters as a needed addition to the operative armamentarium of our colleagues. Until the late 1960s, most of the flaps were tubed or delayed, and since the early 1970s there has been a significant development of pedicled vascularized tissues, either advanced, rotated, or transpositioned into a deficient recipient site. The literature is rich in this field, with numerous flaps published as technical notes, case reports, and anecdotal comments. The scientific support by research in the areas of vascularization and tissue healing expanded the knowledge and therefore increased the predictability of the use of flaps. The objective of the presentation is to address the concepts of the design of local flaps with a “problem-solving” approach based on the anatomic and physiologic basis of each flap, the clinical data accumulated through the literature, and the clinical experience of the presenters. The indications for the use of different flaps as well as the short- and long-term results will be discussed. References Baker SR, Swanson NA: Local Flaps in Facial Reconstruction. St Louis, MO, Mosby, 1995 Jackson IT: Local Flaps in Head and Neck Reconstruction. St Louis, MO, Mosby, 1985 Urken ML, Cheney ML, Sullivan MJ, et al: Atlas of Regional and Free Flaps for Head and Neck Reconstruction. New York, NY, Raven Press, 1995