It is crucial to reconstruct extensive soft tissue defects following oral cancer resection to restore both function and aesthetics. Single anterolateral thigh flaps may not suffice for large defects. This report highlights the use of chimeric flaps, which feature multiple paddles with individual perforators, to reconstruct large intraoral and extraoral defects, adapting to wide defects, and covering areas with extensive tissue damage. This case series demonstrates the adaptability and effectiveness of chimeric flaps, demonstrating them to be a superior option for satisfactory healing and functional outcomes in reconstruction of complex defects.
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http://dx.doi.org/10.5125/jkaoms.2024.50.6.361 | DOI Listing |
Microsurgery
January 2025
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Thinning of anterolateral thigh flap is challenging. Anatomical studies have shown variations in arterial branching patterns in the subcutaneous layer, which were suspected to be the reason for the high frequency of thinning failures. We attempted to visualize subcutaneous arterial courses preoperatively and perform thinning of perforator flaps using this information appropriately.
View Article and Find Full Text PDFJ Korean Assoc Oral Maxillofac Surg
December 2024
Department of Oral and Maxillofacial Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
It is crucial to reconstruct extensive soft tissue defects following oral cancer resection to restore both function and aesthetics. Single anterolateral thigh flaps may not suffice for large defects. This report highlights the use of chimeric flaps, which feature multiple paddles with individual perforators, to reconstruct large intraoral and extraoral defects, adapting to wide defects, and covering areas with extensive tissue damage.
View Article and Find Full Text PDFIndian J Plast Surg
December 2024
Department of Burns and Plastic Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India.
We present the case of a 36-year-old male patient with a posttraumatic composite defect of the lower two-thirds of the anterior aspect of the left leg with exposed necrotic tibia in an old, neglected type 3b fracture of the tibia of 9-month duration. The options for definitive soft-tissue cover include microvascular free tissue transfer and cross-leg flaps. In trauma cases, the surrounding tissue is usually damaged, and the recipient vessels are frequently implicated, ruling out the use of a microvascular free flap.
View Article and Find Full Text PDFIndian J Plast Surg
December 2024
Department of Plastic and Reconstructive Surgery, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
A 21-year-old male laborer sustained bilateral degloving injury of the hands with multiple digital amputations and devascularized digits. After X-rays, preliminary debridement was done, when digital amputations were completed, including index ray amputation on both sides. The next day, two anterolateral thigh (ALT) flaps and one second toe transfer were done to restore coverage in the palm and the web and reconstruct the lost thumb.
View Article and Find Full Text PDFAnn Plast Surg
December 2024
From the Department of Hand and Foot Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Background: Complex lower extremity defects are difficult to cover and often require multiple free tissue transfers. Chimeric anterolateral thigh free flaps (ALTF) and peroneal artery perforator free flaps (PAPF) have been designed specifically as an alternative for reconstruction with arterial end-to-side (ETS) anastomosis. We aimed to assess our institutional experience with this technique and to define its role in complex lower extremity reconstruction.
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