engleski

The Role of Folded Multi-Island Vertical Rectus Abdominis Myocutaneous Flap in Reconstruction of Complex Maxillectomy and Midfacial Defects

The rationale and outcomes for reconstruction of complex maxillectomy and midfacial defects using a folded multi-island VRAM flap (MI-VRAM) are analyzed in this study. A retrospective review of prospectively collected database was conducted on all VRAM free flaps used in head and neck reconstruction from 2013 to 2019. A total of 39 cases were identified, of which 21 patients underwent immediate VRAM flap reconstruction for complex maxillectomy and midfacial defects. Variables including age, sex, pathologic subtypes, tumor staging, type of resection, defect classification, adjuvant therapy, complications, follow-up time and reconstructive details were collected. Single skin-island VRAM was used in 10 (47.6%) patients. 11 (52.4%) patients required the use of folded MI-VRAM flap. In 6 (28.6%) patients a TSI-VRAM was used and 5 (23.8%) received a DSI- VRAM. The average size of harvested skin paddle was 15x7.2 cm. Secondary flap contouring was required in 6 (28.6%) patients. There were no cases of total flap loss and no major donor site complications recorded. Folded MI-VRAM flap is a reliable method for reconstruction of complex maxillectomy and midfacial defects. It provides multiple independent skin islands with excellent plasticity and abundant volume of tissue for restoration of facial contours.

maxillectomy ; midface ; reconstruction ; free flap ; multi-island vertical rectus abdominis myocutaneous flap

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