BACKGROUND The free fibular osteocutaneous flap is a commonly used flap for mandible and buccal mucosa reconstruction in head and neck cancer surgery. However, the skin paddle restriction from the intermuscular septum often limits the soft tissue reconstruction. METHODS We have proposed a new modified chimeric fibular osteocutaneous flap design based on the combination of a traditional fibula...

Free flap surgery is overall considered the gold standard in head and neck reconstruction, with a success rate of 95%. The management of a total flap necrosis and which solution, between a pedicled or a second free flap, is safer for a salvage procedure is still controversial. Object of this study is to describe the authors' management of total free flap loss in head and neck reconstruction and...

Recent reports of breast reconstruction with the deep inferior epigastric perforator (DIEP) flap indicate increased fat necrosis and venous congestion as compared with the free transverse rectus abdominis muscle (TRAM) flap. Although the benefits of the DIEP flap regarding the abdominal wall are well documented, its reconstructive advantage remains uncertain. The main objective of this study wa...

BACKGROUND The purpose of this study was to compare complications and dental implant success between the bone-impacted fibula free flap (BIFFF) and the traditional fibular free flap used in mandibular and midface reconstruction. METHODS Retrospective review of all patients undergoing BIFFF or traditional fibular free flap reconstruction from 2001 to 2009 was undertaken. Complications related ...

BACKGROUND Advanced and recurrent cutaneous squamous cell carcinoma of the scalp and forehead require aggressive surgical excision often resulting in complex defects requiring reconstruction. This study evaluates various microvascular free flap reconstructions in this patient population, including the rarely utilized radial forearm free flap. PATIENTS AND METHODS A retrospective review of pat...

not to speak or chew too much to prevent needle migration, which might be caused by facial muscle contraction. Therefore, when we performed the removal operation, the embedded needle was located 2 cm away from the opening (Fig. 4). In this case, the embedded foreign body had migrated. Acupuncture needles, fish bones, and broken dental needles are very hazardous foreign bodies that can migrate t...

OBJECTIVE To determine the efficacy of using palatal island flaps in combination with free tissue transfer for reconstruction of large, complex oral cavity defects. STUDY DESIGN Prospective evaluation of patients with large, combined defects of the oral cavity reconstructed with palatal flaps in conjunction with microvascular free tissue transfer. METHODS Elevation of a palatal flap was per...

BACKGROUND Microvascular reconstruction for oncologic defects is a challenging and rewarding endeavor, and successful outcomes are dependent on a multitude of factors. This study represents lessons learned from a personal prospective experience with 100 consecutive free flaps. METHODS All patients' medical records were reviewed for demographics, operative notes, and complications. RESULTS O...

BACKGROUND Over the last several decades, reconstruction of the head and neck oncologic defect has been revolutionized by the use of microvascular free tissue transfer. The majority of these defects can be reconstructed with the ability to visually monitor the flap, to intervene as soon as vascular compromise becomes evident. Occasionally, it is necessary to use a flap that has no visual extern...

The loss of a free flap is a feared complication for both the surgeon and the patient. Early recognition of vascular compromise has been shown to provide the best chance for flap salvage. The ideal monitoring technique for perioperative free flap ischemia would be noninvasive, continuous, and reliable. Visible light spectroscopy (VLS) was evaluated as a new method for predicting ischemia in mic...