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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2014, Number 1

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An Med Asoc Med Hosp ABC 2014; 59 (1)

Head and neck reconstruction with free perforator flaps

Priego BR, Villanueva MA

Language: Spanish
References: 24
Page: 16-22
PDF size: 340.01 Kb.


ABSTRACT

Introduction: Reconstruction of head and neck is a challenge for the surgeon; perforator flaps are one of the best reconstructive options, which produce functional and aesthetic results. The objective of this study was to analyze the aesthetic and functional results obtained with the use of perforator flaps for reconstruction of head and neck, preoperative planning, complications and optimizing tissue. Material and methods: We included 50 patients with oncologic disease and vascular malformations in the head and neck, candidates to microsurgical reconstruction, between January 2008 and December 2011 at the General Hospital of Mexico. Results: The age range was 12 to 74 years, with a mean of 38.34 years. 52 surgical procedures were performed: six lateral thigh flaps (11.53%), 41 anterolateral thigh flaps (78.84%), four fibula flaps (7.69%), one radial forearm perforator flap (1.92%); in 12 cases an anterolateral flap was combined with a fibula flap (23.07%). The average size of the flap skin island was 540 cm2, from two to five perforators were identified, and the average length of the pedicle was 7.8 cm. The anterolateral thigh flap island had an average size of 294.31 cm2, from one to three perforating tools were identified, and the average length of the pedicle was 11.44 cm. Two flaps were lost due to venous thrombosis, and thus another free flap was required. In 84% of the cases, patient satisfaction was from good to excellent. Discussion: Head and neck reconstruction with perforator flaps reduces the number of surgical procedures and allows three-dimensional designs that are perfectly suited to the characteristics of the defect.


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