Osteomyocutaneous peroneal artery–based combined flap for reconstruction of composite and en bloc mandibular defects

Abstract

Advantages of the OPAC flap include a single donor site, 1 pair of recipient vessels, versatile 3-dimensional inset, adequate soft tissue augmentation, and better aesthetic and functional outcomes.

Oromandibular Reconstruction With Chimeric Double-Skin Paddle Flap Based on Peroneal Vessel Axis for Synchronous Opposite Double Oral Cancer

“…Moreover, double-skin paddle peroneal tissue transfer has been successfully applied for complex oromandibular defects. [8][9][10] Therefore, this chimeric design based on 2 individual perforators would be practical for the simultaneous reconstruction of these concomitant separate oromandibular defects.…”

“…Based on the peroneal vessel axis, a fibular osteomyocutaneous (OMC), fibular osteocutaneous, or peroneal fasciocutaneous (FC) flap could be designed to provide multiple components of a bony segment, muscle, and skin (even a double-skin paddle) at one transfer. [8][9][10] We previously reported a case of concomitant double oral cancer reconstruction by means of a chimeric double-skin paddle fibular OMC flap. 15 This article describes our further experience with a larger case series, using this chimeric flap based on the peroneal artery axis for the simultaneous reconstruction of all composite defects, including bone, soft tissue, and 2 separate intraoral lesions, even consisting of through-and-through oral defects.…”

“…After tumor ablation, 2 separate oromandibular defects, even combined with through-and-through oral cavity defects, pose a serious reconstructive challenge. Options for reconstruction include combined free flap with local flap, 1 combined multiple free flaps, 2-7 chimeric perforator flap based on the peroneal vessel [8][9][10] and lateral circumflex vessel, 11,12 and a sequential chimeric anterolateral thigh (ALT) flap. 13 After the first free fibular bone transfer was reported by Taylor et al, 14 fibular flaps gradually became the first choice for mandibular reconstruction.…”

Reconstruction of Through-and-through Oromandibular Defect: Comparison of Four Different Techniques

“…The OPAC flap, first described by Cheng et al 15 in 2009, is a refinement of the fibula OSC flap, with the inclusion of partial soleus muscle based on an independent myocutaneous perforator. For the double-flap method, the 2 free flaps of choice commonly used at the Chang Gung Memorial Hospital are the fibular osteocutaneous flap and the ALT flap.…”

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

“…The concept is widely adopted by plastic surgeons in the reconstruction of complex defects because it can minimize injury of the recipient vessels, shorten operative time and lower operative risk [6,9].…”