Objective: To evaluate the reliability of skin paddle in monitoring blood flow after free fibular osteocutaneous composite flap transfer.
Methods: Seven hundred and fourteen consecutive cases of mandibular or maxillary reconstruction using free fibular flap from May 1999 to September 2007 were reviewed. The cases with postoperative vessel thrombosis were analyzed.
Results: Postoperative vessel thrombosis occurred in 23 cases, 17 were venous and 6 arterial. Among 14 cases of venous thrombosis with color change of skin paddles, only 6 were successfully salvaged, but 3 cases with no color change of skin paddles were all successfully salvaged. For arterial thrombosis, only one flap was successfully salvaged. The postoperative vessel thrombosis rate was 3.2%, and the salvage rate was 43.5%. The overall successful rate of free fibula flap was 98.2%.
Conclusions: Postoperative vessel thrombosis can not be detected in the early stage if only observing the color change of skin paddle after free fibula flap transfer.
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