Reconstruction of Midfacial Defect Using Various Free Flap

중안면부 복합조직결손부의 재건을 위한 다양한 유리피판술의 선택

  • Cho, Jae Hyun (Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine) ;
  • Lee, Won Jai (Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine) ;
  • Lew, Dae Hyun (Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine) ;
  • Rah, Dong Kun (Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine) ;
  • Tark, Kwan Chul (Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine)
  • 조재현 (연세대학교 의과대학 성형외과학교실, 인체조직복원연구소) ;
  • 이원재 (연세대학교 의과대학 성형외과학교실, 인체조직복원연구소) ;
  • 유대현 (연세대학교 의과대학 성형외과학교실, 인체조직복원연구소) ;
  • 나동균 (연세대학교 의과대학 성형외과학교실, 인체조직복원연구소) ;
  • 탁관철 (연세대학교 의과대학 성형외과학교실, 인체조직복원연구소)
  • Received : 2006.01.24
  • Published : 2006.05.10

Abstract

Various vascularized free flaps have been used for midfacial reconstruction after ablative head and neck cancer surgery. The most common donor sites for free flap include latissimus dorsi, rectus abdominis, and radial forearm. Between 1994 and 2004, 14 patients underwent free flap operation after head and neck cancer ablation, and were reviewed retrospectively. Among 14 free flaps, 8 were latissimus dorsi myocutaneous flaps, 3 rectus abdominis myocutaneous flaps and 3 radial forearm flaps, respectively. The overall survival rate of the flap was 100%. Complications were wound dehiscence(5 cases) and ptosis(1 case). We designed multiple dimensionally folded free flap for midfacial reconstruction. For 3-dimensional flap needs, we used latissimus dorsi myocutaneous flap. 2-Dimensional flap was latissimus dorsi or rectus abdominis myocutaneous flap and 1-dimensional flap was radial forearm flap. In this study we produced an algorithm for midfacial reconstruction. Large volume with many skin paddle defects were best reconstructed with latissimus dorsi myocutaneous flap or rectus abdominis myocutaneous flap. Radial forearm flap was used for reconstruction of small volume and little skin paddle defects.

Keywords

References

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