Latissimus-Serratus-Rib Free Flap for Oromandibular and Maxillary Reconstruction

Abstract

To review complications and outcomes associated with latissimus-serratus-rib free flap oromandibular and midface reconstruction.Design: Retrospective medical record review.Setting: Two academic tertiary care medical centers.Patients: Twenty-eight patients with segmental resection of the mandible and 1 patient with combined resection of the mandible and maxilla after excision of neoplasms of the oralcavity,whowerebelievedtobepoorcandidatesforfibula free flap reconstruction, were identified.Interventions: Twenty-seven latissimus-serratus-rib osteomusculocutaneous free flap reconstructions and 2 serratus-rib osteomuscular free flap reconstructions were performed. Main Outcome Measures:The outcome of micro-vascular free tissue transfer as well as short-and longterm complications were recorded.Results: There were no perioperative free flap failures. Delayed partial rib graft resorption occurred in 1 patient 33 months after free flap transfer for maxillary reconstruction. Among 28 cases of mandibular reconstruction, 1 case of bone graft nonunion was noted after a postoperative period of 57 months. All other cases achieved successful restoration of mandibular continuity. Donor site morbidity was well-tolerated in all patients. Conclusion:Latissimus-serratus-rib osteomusculocutaneous free flaps are effective for reconstruction of composite defects of the mandible in patients who are not candidates for more commonly used vascularized bonecontaining free flaps.

Mandibular reconstruction with vascularised bone flaps: a systematic review over 25 years

“…By contrast, the Serratus anterior and rib accounted for just 63 flaps (8, 67,90,107,108,113,128,107,149,108,226), while the metatarsal accounted for 32 (17) and lateral arm including humerus for just 10 (72, 167). The trend for reporting by donor site is set out in Table 3.…”

A New Method of Limb Salvage and Functional Upper Limb Reconstruction

“…The Leed-Keio ligament is made of polyester woven into an open mesh-like structure [17]. After implantation, longitudinally aligned collagen-fiber bundles with spindle-shaped nuclei form over the polyester matrix [18,19].…”

Thinned chimeric radial collateral artery perforator flap in complex distal thumb reconstruction

“…Such flaps include fibula osteocutaneous flaps [29,41], iliac osteocutaneous flaps [34], osteocutaneous flap from the medial femoral condyle [19,33], osteocutaneous radial forearm [20], osteocutaneous posterior interosseous artery flap [1], and vascularized ribs with serratus anterior and latissimus dorsi [23]. However, these flaps may be unnecessary in small defects such as those less than 15 cm 2 .…”