Compound Flap Research Articles

One-stage reconstruction of a massive gun-shot wound of the lower face with a local compound osteo-musculocutaneous flap

A case is reported in which a large oro-facial traumatic defect was reconstructed in one stage with a compound osteo-musculo-cutaneous flap based on the pectoralis major muscle. A simple manoeuvre was used to show that the rib in the flap was in fact a viable constituent of the compound flap and not an inert graft.

Reconstruction of Mandible with Free Osteocutaneous Flap Using Deep Circumflex Iliac Vessels as the Stem

One of the 2 patients introduced here had osteoradionecrosis, which has been difficult to reconstruct. The other had a massive adamantinoma that required replacement of the mandible from the midportion of the right ramus to the left angle with the iliac bone using the conventional method. The grafted iliac bone was severely absorbed, however. The mandible in both cases was successfully reconstructed with an osteocutaneous compound flap, using the deep circumflex iliac vessels as the stem. This method is considered a very good procedure for reconstruction of the mandible, which has been difficult by conventional procedures. Because the diameter of the stem is large, vascular anastomosis can be readily performed with an extremely high degree of safety. Pulsation of the stem can be palpated on follow-up even one year after surgery, and there are no signs of bone reabsorption.

The sternocleidomastoid muscle-skin compound flap for reconstruction of traumatic loss of bone and soft tissues of the mandibular region. (Italian)

The sternocleidomastoid muscle-skin compound flap for reconstruction of traumatic loss of bone and soft tissues of the mandibular region. (Italian)

The sternocleidomastoid myocutaneous flap.

The sternocleidomastoid muscle has three blood supplies: the occipital artery superiorly, the superior thyroid in the middle, and the thyrocervical trunk inferiorly. A compound flap has been developed to transport segments of neck skin on either end of a pedicle of sternocleidomastoid muscle to reconstruct defects in the oral cavity or orophaynx. It permits one-stage reconstruction at the time of the primary resection and eliminates the need for skin grafts to the donor sites.

The sternocleidomastoid myocutaneous flap.

A myocutaneous flap based on the sternocleidomastoid muscle appears useful in selected circumstances when preservation of the sternocleidomastoid does not compromise oncologic safety. Its principal advantage lies in the single-stage repair of smaller oropharyngeal defects not exceeding 6 cm in diameter. Of the five flaps included in this series, one underwent total cutaneous necrosis; in two of five, partial cutaneous loss developed. Despite varying degrees of epithelial loss, fistulae did not develop because of viable underlying muscle present in this compound flap.

Pectoralis Major, Sternomastoid, and Other Musculocutaneous Flaps for Head and Neck Reconstruction

The development of the new myocutaneous flaps has ushered in an era of one-stage reconstructions that have already changed the patterns of surgery for head and neck cancer. The availability, the technical ease of the surgical procedures, and the reliability of these compound flaps make them very attractive for widespread use for reconstructions at a variety of sites. The experience gained from the use of these new flaps has confirmed their safety and versatility. They have decreased the disability and shortened the hospital stay for these patients.

Superiority of the Deep Circumflex Iliac Vessels as the Supply for Free Groin Flaps Clinical Work

In this paper we present 16 cases of free transfer of compound flaps from the groin, 11 using the deep circumflex iliac vessels as a stem and 5 using the superficial circumflex iliac vessels as a stem. We found the deep vessels superior in many ways to the superficial vessels for this purpose; they are larger, permitting greater ease in anastomoses and providing more reliable blood flow. We believe that larger osteocutaneous or myocutaneous flaps can be transferred on the deep vessels than on the superficial ones-and that the deep circumflex iliac flap may supplant the conventional free going flap in most situations. The method evolved in response to patient need, not for surgical éclat.

The Pectoralis Major Myocutaneous Flap A Versatile Flap for Reconstruction in the Head and Neck

A compound flap is described that utilizes skin from the anterior chest on a narrow segment of pectoralis major muscle, with its underlying axial neurovascular bundle. This flap has been used successfully to reconstruct large defects in 4 consecutive patients. Our experience with this flap suggests that it may be more versatile than the deltopectoral flap.

GLUTEUS MAXIMUS MUSCLE ISLAND FLAPS FOR REPAIR OF SACRAL RADIATION ULCERS

A free gluteus maximus compound flap transfer to the chest was firstly reported by Fujino.1 The gluteus maximum muscle flap2, 3, 4, 5 and recently developped musculocutaneous flaps have been the chosen method of coverage of sacral pressure sores.In this report, we present the gluteus maximus island flap successfully used in the reconstruction of sacral radiation ulcers.

The musculo-cutaneous cross leg flap

The authors present a musculo-cutaneous cross leg flap using the medial head of the gastrocnemius muscle to cover a defect of the contralateral foot resulting from a chronic traumatic ulcer. The inclusion of the well vascularized muscle portion into a compound flap increases the safety of the cross leg procedure. The functional and aesthetic defect of the donor site is minimal.

THE FREE MUSCULOCUTANEOUS FLAP

We report the transfer of a free musculocutaneous compound flap, including the gracilis muscle, in one stage by microvascular surgery. The advantages of this free flap are discussed.