AI Article Synopsis

  • Large facial defects have historically been repaired using cervicofacial rotation flaps; this study examines the effectiveness of SMAS island flaps for such reconstructions.
  • A retrospective analysis of 36 patients (predominantly male, average age 69) who had undergone flap surgery between 2009 and 2023 revealed a mean flap advancing distance of 3.8 cm, with a low incidence of ischemia (8%).
  • The results suggest that SMAS island flaps are reliable for large cheek defects, with anterior pedicles being preferable for anterior defects and posterior pedicles for those located in the back.

Article Abstract

Large cutaneous defects of the face have traditionally been reconstructed with cervicofacial rotation flaps. To measure advancing distance and assess vascular reliability of superficial musculoaponeurotic system (SMAS) island flaps for reconstruction of large cutaneous facial defects. The study design was a retrospective case series of all patients who had undergone reconstruction of facial defects 3 cm or greater with fasciocutaneous SMAS island flaps from 2009 to 2023. Flap advancing distance and vascular compromise were analyzed. The average patient age at the time of surgery was 69 (standard deviation [SD] 15) years with more males ( = 33, 92%) than females ( = 3, 8%). Of 36 patients, 18 had posterior defects, 16 had anterior defects, and 2 had defects straddling both regions. Fifteen cases had a full fasciocutaneous SMAS island flap, and 21 underwent the partial island modification. Flap ischemia occurred in three cases (8%). The mean flap advancing distance was 3.8 cm (SD 1.1). Of the 5 smokers, none had ischemia of the flap. The median follow-up time was 2 years (range 12-3,170 days). Fasciocutaneous SMAS island and partial island flaps are reliable options for the reconstruction of large cheek defects (3 cm or greater). Anterior pedicle blood supply is more reliable for defects anterior to the line from the lateral brow to the angle of the mandible, whereas the posterior pedicle is a better choice for defects posterior to that line.

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Source
http://dx.doi.org/10.1089/fpsam.2024.0194DOI Listing

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