Supine positioning for the subscapular system of flaps: A pictorial essay

Eskander, Antoine; Kang, Stephen Y.; Özer, Enver; Agrawal, Amit; Carrau, Ricardo L.; Rocco, James W.; Teknos, Theodoros N.; Old, Matthew

doi:10.1002/hed.25051

Cited by 20 publications

(29 citation statements)

References 19 publications

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“… 43 Ablation and harvesting can be simultaneously performed in this modified supine position to reduce the surgery time, thereby ensuring a low chance of developing SSI; however, the disadvantage is that it requires a two-team approach simultaneously. 43 …”

Section: Discussionmentioning

confidence: 99%

Risk factors for surgical site infection after major oral oncological surgery: the experience of a tertiary referral hospital in China

et al. 2020

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Objective To identify risk factors associated with surgical site infection (SSI) after major oral oncological surgery. Methods This retrospective study reviewed data from patients that underwent major surgery for oral cancer at a tertiary referral hospital in China between January 2005 and July 2016. SSI was diagnosed within 30 days. Demographic, cancer-related, preoperative, perioperative and postoperative data were analysed using descriptive statistics and univariate and multivariate analyses of the risk factors for SSI. Results A total of 786 patients were enrolled, of whom 125 had SSI (15.9%), which were all incisional. Independent risk factors for SSI, identified by multivariate analysis, were diabetes mellitus (odds ratio [OR] 2.147, 95% confidence interval [CI] 1.240, 3.642), prior radiotherapy (OR 4.595, 95% CI 1.293, 17.317) and oral–neck communication (OR 2.838, 95% CI 1.263, 7.604); and factors reflecting large extent resections were tracheostomy (OR 2.235, 95% CI 1.435, 3.525), anterolateral thigh flap (OR 1.971, 95% CI 1.103, 3.448) and latissimus dorsi flap (OR 4.178, 95% CI 1.325, 13.189). Conclusions Multiple risk factors were associated with SSI after major oral oncological surgery. To minimize SSI risk, surgeons managing oral cancer patients should have a better understanding of the risk factors, including diabetes mellitus, prior radiotherapy, tracheostomy, oral–neck communication and flap reconstruction.

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Section: Discussionmentioning

confidence: 99%

Risk factors for surgical site infection after major oral oncological surgery: the experience of a tertiary referral hospital in China

et al. 2020

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“…The patient is prepped for the harvest and resection simultaneously and no repositioning is necessary. Although we routinely do not two‐team scapula flaps, it is possible as demonstrated in the literature …”

Section: Discussionmentioning

confidence: 99%

Mandibular reconstruction with the scapula tip free flap

et al. 2019

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Introduction: The scapula tip free flap has been described for reconstruction of short mandible defects with extensive soft tissue needs. The versatility of this flap has not been extensively described. Methods: Retrospective case series of patients who underwent mandibulectomy and reconstruction with the scapula tip free flap from 2005 to 2016. Outcomes include bony union, complications, dental rehabilitation, and donor site morbidity. Results: A total of 120 patients were identified. Average harvested bone was 7.7 cm, with 54% undergoing one osteotomy, and 76.7% harvested as a chimeric flap. Radiographically, average inset bone was 6.6 cm. Complete or partial bony union was observed at 74.4% of proximal and 82.6% of distal osteotomies. A 95% of reconstructions met criteria for dental implants. Mean disabilities of the arm, shoulder and hand score was 21.2. Conclusions: The scapular tip is an excellent option for reconstruction of segmental mandible defects with the option of osteotomy, excellent bony union rates, low donor site morbidity, and potential for dental rehabilitation.

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“…Traditionally, a harvest of a free or pedicled latissimus dorsi flap has been described through intraoperative patient re-positioning or sequential surgery [21,28,32,33] . However, more recent descriptions have used a supine position to eliminate the need for repositioning and allow a two-teamed approach [34][35][36] . The use of an upper extremity limb positioner (Spider Limb Positioner) to facilitate a simultaneous two teamed approach is described extensively by Stevens et al [25] .…”

Section: Positioningmentioning

confidence: 99%