BACKGROUND
Functional and cosmetic outcomes affect reconstruction of the face more than any region of the body. To use a predetermined perforator flap freely designed allowing a wide range of movement and manipulation can give us an optimum outcome. We present our clinical experience with free style facial perforator flaps, surgical technique, and complications.
METHODS
Thirty patients with post-tumor resection of the face were reconstructed with free style local perforator flaps between January 2014 and November 2016. Doppler was used to identify the perforator vessels preoperatively.
RESULTS
Twenty-two clinical cases had no complications. Four had venous congestion that resolved spontaneously, three had a distal 1/3 superficial necrosis, and one suffered from hematoma.
CONCLUSION
Freestyle perforator flaps were applied to get better cosmetic facial reconstruction, allowing one stage procedure and decreasing donor site morbidity. Modern anatomical understanding, good planning, and meticulous surgical technique can affect clinical results.
Background: The reconstructive ladder is an old concept that is familiar to all plastic surgeons. It is an arrangement of methods to reconstruct tissue defects from the easy to most complex one. With the advent of surgery, a lot of flimsy spots and difficulties showed up and yet showing up with the utilization of this old reconstructive stepping stool.Objective: In this work, the authors will present another view of the reconstructive ladder that they incited that is more valuable to the patient than the bygone one.Patients and Methods: The authors discussed six clinical cases. In each case, a travel study comparing the use of all the steps of the ladder to reach the best.
Results:The discussion of the clinical cases that included other reconstructive options demonstrated and affirmed the requirement for modifications in the reconstructive ladder.
Conclusion:The addition of the pedicled freestyle perforator flap would be a valuable update to the reconstructive ladder. The reconstructive Ladder is better viewed and organized as an order of beneficial priority to the patients rather than a classification of reconstructive options from simplicity to sophistication.
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