Free posterior tibial artery perforator flapin head and neck reconstruction after tumor expiration

Abstract

Objectives: The purpose of this study was to examine the anatomical features, clinical applications, and complications of the free posterior tibial flap in head and neck reconstruction.Methods： Patients treated with free posterior tibial artery perforator flap in head and neck surgery were retrospectively viewed. Results： A total of 55 patients underwent reconstruction with a free posterior tibial artery perforator flap. Most of the patients had carcinoma of pharynx, trachea, oral and maxillofacial region. The flap dimension ranged from 7.5 cm2 to 108 cm2. The mean thickness of the flap was 1cm. The average length of the vascular pedicle is about 10 cm. Functional recovery of reconstruction area was studied 5~100 months after surgery. The flap survival rate was 98.1%. Specifically speaking, 3 patients developed Partial flap loss and 1 patient developed Total flap loss. Regarding ablative site complications, 6 patients developed wound infection, 2 of them, and another 2 patients developed pharyngeal fistula in the ablative area. Regarding donor site complications, 7 patients developed delayed wound healing and 5 patients developed skin graft necrosis. None of the patients complained of walking difficulty in daily life.Conclusion: Free posterior tibial artery perforator flap as a relatively novel flap, with stable blood supply, thin thickness, flexible cortex, long vascular pedicle, and concealed donor area, is very suitable for head and neck reconstruction. Though PTAFs harvest will produce a minor donor site morbidity which could be solved mostly by conservative treatment, we think PTAFs will become one of the popular techniques for reconstruction of head and neck soft tissue defects.