Femoral artery-nourished anteromedial thigh flap: A new perspective in oral and maxillofacial defect reconstruction

Gong, Zhaojian; Zhang, Shanshan; Li, Panchun; Liu, Jiang; Xu, Yuming

doi:10.1016/j.oraloncology.2021.105295

Cited by 3 publications

(4 citation statements)

References 27 publications

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“…Gong et al 17 used SFA-nourished AMTF to reconstruct oral and maxillofacial defects, as a new alternative to the ALTF. They stated that the esthetic and functional outcomes were similar to those of ALTF.…”

Section: Discussionmentioning

confidence: 99%

Perforators of the Anteromedial Thigh Skin and Possible Design of the Anteromedial Thigh Flap

et al. 2022

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Background: Specific perforator-based flaps are a new era in plastic reconstruction. They have replaced many of the traditional paradigms in plastic surgery. The anteromedial thigh flap is a versatile flap that can be used as a primary choice for many reconstructive purposes or as a secondary choice for the anterolateral thigh flap. Mapping the vascular territory of anteromedial thigh is essential for the proper design of the flap. Aim of the Work: The aim of this work was to study the cutaneous perforators of the anteromedial thigh and explain their significance in flap design. Material and Methods: The material of this study included 30 fresh cadaveric lower limbs. The external iliac artery was injected with colored latex. Superficial and deep dissections were undertaken under a magnifying lens to locate the perforators and identify their type. The length and diameter of the perforators were measured. Results: Anteromedial thigh skin was divided into 6 squares. Squares 1 and 4 are the upper squares and comprise the skin over the upper medial thigh. It is primarily based on the superficial external pudendal artery, deep external pudendal artery, and superficial circumflex femoral artery. Squares 2 and 5 are the middle squares and were mainly supplied by perforators of the superficial femoral artery. Squares 3 and 6 are the lower squares and were mainly supplied by the saphenous artery and superficial femoral artery. The possible flap designs are then discussed. Conclusion:The anteromedial thigh skin is richly supplied by a mixture of perforators from multiple sources. The segmental nature of the perforators arising from the superficial external pudendal artery, deep external pudendal artery, superficial femoral artery, and saphenous artery together with the long course and large diameter of perforators grant the anteromedial thigh flap its versatility.

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Section: Discussionmentioning

confidence: 99%

Perforators of the Anteromedial Thigh Skin and Possible Design of the Anteromedial Thigh Flap

et al. 2022

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“…Owing to the convenient and individualized flap design, large skin territory, sufficient softtissue supply, long pedicle and suitable vessel caliber, minimal and acceptable donor site morbidity, and high success rate of transplantation, the ALT flap has been referred to as a "versatile soft-tissue flap" (4,18). Many groups, including ourselves, have considered the ALT flap or its chimeric flaps as the preferred choice for oral and maxillofacial soft-tissue defect reconstruction after tumor resection (7,15).…”

Section: Discussionmentioning

confidence: 99%

“…Varying-sized dead spaces are often left in these lateral skull base defects, leading to wound infection or effusion and even more serious complications (4). The reconstruction of such defects remains a reconstructive challenge because of the limited local tissue supply and extremely visible location (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

“…Among them, the ALT flap, which was first introduced in 1984 by Song et al (14), is a good candidate. With noticeable advantages and acceptable donor site morbidity, this flap has been increasingly applied in recent years (5,7,(15)(16)(17). The ALT flap is nourished by the lateral circumflex femoral artery (LCFA), and the classic ALT flap or its chimeric flaps are pedicled with the descending branch (DB), the largest and longest branch of the LCFA (4,17).…”

Section: Introductionmentioning

confidence: 99%

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Reconstruction of Complex Lateral Skull Base Defects After Oral Cancer Resection With Individualized Anterolateral Thigh Flap

et al. 2021

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ObjectivesComplex lateral skull base defects resulting from advanced or recurrent oral cancer resection are continuously challenging reconstructive surgeons. This study aimed to use reconstructive methods for lateral skull base defects, explore their feasibility, and evaluate the efficacy of defect reconstruction using anterolateral thigh (ALT) flaps.Patients and MethodsWe performed a retrospective case series of 37 patients who underwent lateral skull base defect reconstruction using the ALT/anteromedial thigh (AMT) flap between March 2016 and May 2021 at the Second Xiangya Hospital. The design and harvest of the flaps, methods for defect reconstruction, and reconstructive efficacy are described.ResultsOf the 37 patients, 3 were women and 34 were men, with a mean age of 51.7 years. Among the defects, 26 were through-and-through defects and were reconstructed using ALT chimeric flaps, double ALT flaps, folded ALT flap, combined ALT chimeric flaps and AMT flaps, or combined ALT chimeric flaps and pectoralis major flaps; the large lateral skull base dead spaces were filled with muscle tissues or fatty tissues. Postoperatively, 38 of the 39 ALT/AMT flaps survived completely, and the remaining flap experienced partial necrosis. Venous compromise occurred in one patient who was salvaged after operative exploration. Oral and maxillofacial wound infections occurred in two patients, salivary fistula in three patients, and thigh wound effusion in three patients. The wounds healed gradually in all patients after repeated dressing changes. Thirty-three patients were followed up for approximately 3–60 months; their oral functions and appearance were acceptable, and thigh motor dysfunction was not observed.ConclusionsWith the convenient flap design and muscle flap harvest, large and individualized tissue supply, feasible combination with other flaps, effective reduction or avoidance of wound complications, and acceptable donor site morbidity, the ALT flap is an appropriate choice for complex lateral skull base defect reconstruction.

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3D printing materials and 3D printed surgical devices in oral and maxillofacial surgery: design, workflow and effectiveness

Wang,

Mu,

Yan

et al. 2024

Regenerative Biomaterials

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Oral and maxillofacial surgery is a specialized surgical field devoted to diagnosing and managing conditions affecting the oral cavity, jaws, face, and related structures. In recent years, the integration of 3D printing technology has revolutionized this field, offering a range of innovative surgical devices such as patient-specific implants (PSIs), surgical guides, splints, bone models, and regenerative scaffolds. In this comprehensive review, we primarily focus on examining the utility of 3D printed surgical devices in the context of oral and maxillofacial surgery and evaluating their efficiency. Initially, we provide an insightful overview of commonly utilized 3D printed surgical devices, discussing their innovations and clinical applications. Recognizing the pivotal role of materials, we give consideration to suitable biomaterials and printing technology of each device, while also introducing the emerging fields of regenerative scaffolds and bioprinting. Furthermore, we delve into the transformative impact of 3D printed surgical devices within specific subdivisions of oral and maxillofacial surgery, placing particular emphasis on their rejuvenating effects in bone reconstruction, orthognathic surgery, temporomandibular joint (TMJ) treatment, and other applications. Additionally, we elucidate how the integration of 3D printing technology has reshaped clinical workflows and influenced treatment outcomes in oral and maxillofacial surgery, providing updates on advancements in ensuring accuracy and cost-effectiveness in 3D printing-based procedures.

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Femoral artery-nourished anteromedial thigh flap: A new perspective in oral and maxillofacial defect reconstruction

Cited by 3 publications

References 27 publications

Perforators of the Anteromedial Thigh Skin and Possible Design of the Anteromedial Thigh Flap

Perforators of the Anteromedial Thigh Skin and Possible Design of the Anteromedial Thigh Flap

Reconstruction of Complex Lateral Skull Base Defects After Oral Cancer Resection With Individualized Anterolateral Thigh Flap

3D printing materials and 3D printed surgical devices in oral and maxillofacial surgery: design, workflow and effectiveness

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