0100481692

open access

Accepted Manuscript

Strategy for preventing skin paddle necrosis in mandibular reconstruction with free fibula osteocutaneous flap

English (英語)

Microsurgery

42(5)

451-459

John Wiley & Sons

2022-07

2023-04-07

Background Non-thrombotic skin paddle necrosis occasionally occurs during mandibular reconstructions with free fibula osteocutaneous flaps. The number of perforators, size of the skin paddle, and ischemia time of the flap are considered as causes of skin paddle necrosis. The importance of donor side selection has also been highlighted. This study aimed to investigate the leading cause of skin paddle necrosis and the optimal reconstructive procedure. Methods A total of 66 patients who underwent mandibular reconstruction using a free fibula osteocutaneous flap were retrospectively analyzed. Skin paddle necrosis, number of cutaneous perforators, size of the skin paddle, and ischemia time of the flap were investigated. An incorrect “laterality” was defined as a skin paddle (septum) covering the reconstruction plate. Donor-site morbidity was recorded. Results Skin paddle necrosis occurred in 15.2% of patients. An incorrect laterality was associated with a higher incidence of skin paddle necrosis (odds ratio, 22.0; 95% confidence interval, 2.5–195; p = .005). Donor-site morbidity was noted in 18.8% of the patients, without any significant difference in terms of the donor side with and without skin graft (p = .592). The postoperative activities of daily living were not affected. Conclusions To prevent skin paddle necrosis, donor side selection is an important safety strategy during mandibular reconstruction with free fibula osteocutaneous flap. The postoperative activities of daily living were found to be little affected by differences in the donor side.

学術雑誌論文

This is the peer reviewed version of the following article: [Kusumoto, J., Hashikawa, K., Sakakibara, A., Murai, N., & Akashi, M. (2022). Strategy for preventing skin paddle necrosis in mandibular reconstruction with free fibula osteocutaneous flap. Microsurgery, 42(5), 451–459.], which has been published in final form at [https://doi.org/10.1002/micr.30881]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.