Perforator based rectus free tissue transfer for head and neck reconstruction: New reconstructive advantages from an old friend

Kang, Stephen Y.; Spector, Matthew E.; Chepeha, Douglas B.

doi:10.1016/j.oraloncology.2017.06.029

Cited by 12 publications

(2 citation statements)

References 29 publications

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“…19 The rectus when used as a perforator flap has several distinct advantages including minimizing donor-site morbidity, as described by Marchetti et al 20 More recently, Kang et al describe a perforator-based rectus free tissue transfer with the advantages of a long pedicle (average 13.4 cm), moldable adipose tissue, and volume control due to limited muscle harvest and subsequent atrophy. 21 The advantages of the rectus abdominis include tendinous intersections that help facilitate fixation to the skull base, adequate bulk allows obliteration of complex 3D dead spaces, and versatility to be used with or without skin paddle, depending on the degree of bulk demand. The disadvantage of the flap includes large abdominal scar, variable bulk of the flap if skin is used, and susceptibility of patients to postoperative hernia formation.…”

Section: Rectus Abdominismentioning

confidence: 99%

Free-Flap Reconstruction of Skull Base and Orbital Defects

Wang

Vincent

Sokoya

et al. 2019

Seminars in Plastic Surgery

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Orbital and anterior skull base defects present a significant challenge for reconstruction due to the complexity of the anatomy and the need for separation of intracranial and extracranial contents in this area. While endoscopic techniques have revolutionized the treatment of many anterior skull base defects, microvascular free tissue transfer is a viable option for large volume defects not suitable for traditional open approaches or for cases where endoscopic techniques have failed. The various free tissue transfer techniques for anterior skull base and orbit, as well as the advantages and disadvantages, are reviewed.

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Section: Rectus Abdominismentioning

confidence: 99%

Free-Flap Reconstruction of Skull Base and Orbital Defects

Wang

Vincent

Sokoya

et al. 2019

Seminars in Plastic Surgery

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“…A long pedicle length, ability to mold and trim the adipose tissue and lack of muscle nullifying the complications related to muscle atrophy are the potential advantages. [ 16 ] Hence, we conducted a systematic review (SR) and meta-analysis to evaluate the outcomes of glossectomy reconstruction with DIEAP or the MSAP flap.…”

Section: Introductionmentioning

confidence: 99%

Do medial sural artery perforator flaps have better clinical outcomes compared to the rectus abdominis perforator (DIEAP) flap in reconstruction of glossectomy defects? A Prisma guided meta-analysis

Bera¹,

Tiwari²

2021

Ann Maxillofac Surg

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Background: There is an increasing evidence for the use of thin flaps based on vascular perforators for reconstructive surgeries. The medial sural and deep inferior epigastric artery flaps offer versatility for the reconstruction of major defects of the head and neck. Objectives: “Whether medial sural artery perforator (MSAP) flap or rectus abdominis perforator flap is better for the reconstruction of glossectomy defects in terms of functional outcome?” Data Sources: PubMed, Cochrane Library, clinicaltrials.gov and hand searches. Participants and Interventions: Patients who underwent tongue reconstruction with either MSAP flap or deep inferior epigastric artery perforator (DIEAP) flap. Study Appraisal and Synthesis Methods: Based on defined study criteria 6 studies were selected according to Prisma Guidelines. The overall estimated effect was categorized as significant where P < 0.05. Results: There was no significant difference between both flaps in terms of receptor site complications ( P = 0.223). Overall odds ratio (OR) for complications was 1.35 (95% confidence interval [CI]: 0.412–0.736) and the test for overall effect t value was 2.836, P < 0.05. Overall OR was 6.01 (95% CI 0.5–7.45) and the test for overall effect t value was 1.41, P < 0.05 indicating there was a statistical difference in the intelligibility of speech. Limitations: Anatomical variations, under-reporting of studies and lack of universal tool for speech intelligibility. Conclusions and Implications of Key Findings: Both the flaps are comparable in terms of functional outcome. Medium-sized defects can be reconstructed with MSAP and composite larger defects would benefit from DIEAP. In females, anterolateral thigh flap still remains the choice for composite reconstructions.

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