TY - JOUR
T1 - Free thoracodorsal, perforator-scapular flap based on the angular artery (TDAP-Scap-aa): Clinical experiences and description of a novel technique for single flap reconstruction of extensive oromandibular defects
AU - Pau, Mauro
AU - Wallner, Jürgen
AU - Feichtinger, Matthias
AU - Schwaiger, Michael
AU - Egger, Jan
AU - Cambiaso-Daniel, Janos
AU - Winter, Raimund
AU - Jakse, Norbert
AU - Zemann, Wolfgang
PY - 2019
Y1 - 2019
N2 - Purpose:The reconstruction of oromandibular defects can be challenging, particularly when consider-able amounts of bone and soft tissues are lost. In such cases, the use of a singleflap may be unsatisfactoryand a concomitant freeflap is needed. Here we present a chimeric, thoracodorsal perforator-scapular freeflap based on the angular artery of the subscapular system (TDAP-Scap-aa) as an alternative technique forsingleflap reconstruction of extensive oromandibular defects.Materials and methods:The authors studied patients who underwent reconstructions of extensive oro-mandibular defects with a TDAP-Scap-aa freeflap. The operative technique and the clinical experiencesare described. Postoperatively, surgical complications were classified with the Clavien-DindoClassification.Results:Five male patients (59.4±8.8 years) were treated with the TDAP-Scap-aa. Average sizes forharvested hard and soft tissue components, which are both included in theflap and completely inde-pendently from each other, were 10.4±1.5 cm of bone length, 2.6±0.3 cm of bone height, 11.6±4.8 cmof skin paddle length and 8.4±1.7 cm of skin paddle width. The overall mean operation time (cut-suture)was 14.6±0.9 h. The postoperative follow-up was 6 months. No complications requiring surgicaltreatment as well as donor site nerve damages were observed.Conclusions:In comparison to other double freeflaps, the TDAP-Scap-aa offers several advantages suchas higher amounts of hard and soft tissues without prolonged operation times, and provides satisfyingaesthetic outcomes and little donor site morbidity due to the preservation of muscle and nerve struc-tures. Therefore, the TDAP-Scap-aa constitutes a clinically reliable alternative in extensive oromandibular defect reconstruction
AB - Purpose:The reconstruction of oromandibular defects can be challenging, particularly when consider-able amounts of bone and soft tissues are lost. In such cases, the use of a singleflap may be unsatisfactoryand a concomitant freeflap is needed. Here we present a chimeric, thoracodorsal perforator-scapular freeflap based on the angular artery of the subscapular system (TDAP-Scap-aa) as an alternative technique forsingleflap reconstruction of extensive oromandibular defects.Materials and methods:The authors studied patients who underwent reconstructions of extensive oro-mandibular defects with a TDAP-Scap-aa freeflap. The operative technique and the clinical experiencesare described. Postoperatively, surgical complications were classified with the Clavien-DindoClassification.Results:Five male patients (59.4±8.8 years) were treated with the TDAP-Scap-aa. Average sizes forharvested hard and soft tissue components, which are both included in theflap and completely inde-pendently from each other, were 10.4±1.5 cm of bone length, 2.6±0.3 cm of bone height, 11.6±4.8 cmof skin paddle length and 8.4±1.7 cm of skin paddle width. The overall mean operation time (cut-suture)was 14.6±0.9 h. The postoperative follow-up was 6 months. No complications requiring surgicaltreatment as well as donor site nerve damages were observed.Conclusions:In comparison to other double freeflaps, the TDAP-Scap-aa offers several advantages suchas higher amounts of hard and soft tissues without prolonged operation times, and provides satisfyingaesthetic outcomes and little donor site morbidity due to the preservation of muscle and nerve struc-tures. Therefore, the TDAP-Scap-aa constitutes a clinically reliable alternative in extensive oromandibular defect reconstruction
U2 - 10.1016/j.jcms.2019.07.021
DO - 10.1016/j.jcms.2019.07.021
M3 - Article
SN - 1878-4119
VL - 47
SP - 1617
EP - 1625
JO - Journal of Cranio-Maxillofacial Surgery
JF - Journal of Cranio-Maxillofacial Surgery
IS - 10
ER -