The Osteocutaneous Scapular Flap for Mandibular and Maxillary Reconstruction

Swartz, William M.; Banis, Joseph C.; Newton, E D; Ramasastry, Sai S.; Jones, Neil F.; Acland, Robert D.

doi:10.1097/00006534-198604000-00003

Cited by 627 publications

(220 citation statements)

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“…[12][13][14][15][16][17][18] Although there have been advances in plastic surgery, surgical reconstruction of maxillectomy defects continues to be challenging, unpredictable, and not always possible, either due to local or systemic reasons. 19 Additionally, some patients may prefer to avoid secondary morbidity from reconstructive procedures. 20 In these patients an obturator prosthesis can reestablish the separation of the oral cavity from the sino-nasal cavities, restoring speech and swallowing function.…”

Section: Introductionmentioning

confidence: 99%

Zygoma implant-supported prosthetic rehabilitation after partial maxillectomy using surgical navigation: A clinical report

Kreissl

Heydecke

Metzger

et al. 2007

The Journal of Prosthetic Dentistry

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Section: Introductionmentioning

confidence: 99%

Zygoma implant-supported prosthetic rehabilitation after partial maxillectomy using surgical navigation: A clinical report

Kreissl

Heydecke

Metzger

et al. 2007

The Journal of Prosthetic Dentistry

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“…The clinical use of the scapula free flap was first reported in 1986 (Swartz et al, 1986). Since then, it has remained a popular choice for the complex microsurgical reconstruction of the maxillofacial area due to its ability to tolerate multiple osteotomies with a thin blade and the potentially large skin paddle (Siemionow et al, 2006;Sakurai et al, 2005).…”

Section: ⅱ) Scapula Flapmentioning

confidence: 99%

“…Moreover, its thick skin paddle, short vascular pedicle, and limited availability of bone segment remain its principal disadvantages (Swartz et al, 1986). Moreover, the donor-site morbidity may be high, with large scars extending across the back .…”

Section: ⅱ) Scapula Flapmentioning

confidence: 99%

Mandibular Reconstruction with Vascularized Osseous Free Flaps: a Review of the Literature

Kim

Nam

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Purpose: This article reviews a few of the commonly used types of vascularized osseous free flaps in maxillofacial reconstruction, which still represents the gold standard of restoration. We also discuss the developing concepts in maxillofacial reconstruction. Recent findings: Most of the literature reconfirms the established patterns of reconstruction with the aid of vascularized osseous free flaps. This method of freetissue transfer is also feasible in cases of osteoradionecrosis or bisphosphonate-related osteonecrosis of the jaw. These flaps are also suitable for prosthetic restoration using osseointegrated dental implants. Summary: Vascularized osseous free flaps still remain the standard of care. Improvements upon the free-tissue transfer method employing vascularized osseous free flaps, such as distraction osteogenesis, tissue engineering, and imaging techniques, currently require further development, but these technologies could lead to improved outcomes of maxillofacial reconstruction in the near future.

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“…The late 1970's and early 1980's were an age of anatomy. Examples of this are Taylor, McGregor, and Jackson's work on the DCIA flap and Bill Swartz's development of the scapular flap [3][4][5]. The 80's was an age of application as free flaps became more accepted and usefulness increased [6,7].…”

Section: Introductionmentioning

confidence: 99%

Anatomy of Free Flap Failures: Dissection of a Series

Davison¹,

Clemens²,

Kochuba³

2013

MPS

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Introduction: Free flap success rates have remained stable in recent years ranging 93% to 98%. Historically, the causes of free flap failures were attributed to the surgeon's inexperience and technique. However, there are factors beyond the surgical anastomosis that contribute to flap failure. The purpose of this study is to review each case of total flap loss in detail to develop a better understanding of complications. Methods: A retrospective study was performed over eleven years in a single surgeon's practice, a predominantly head and neck reconstructive practice. All charts were independently reviewed. In patients who sustained total flap loss, a review was conducted of patient comorbidites, anesthesia records, perioperative and follow-up notes. Results: A total of 514 free flaps were performed. 76% (392) of these flaps were for head and neck reconstruction. There were 22 total flap losses (4%) and 26 partial flap losses (5%). Of the 22 total flap losses, four flaps were avulsed, five flaps were in patients later found to have coagulation disorders (homozygous mutations of the MTHFR gene and factor V Leiden), four patients were exposed to neosynephrine, two patients remained hypotensive perioperatively, and four delayed flap losses were attributed to pseudomonal infection. Five losses were technical or related to flap inexperience. Several representative case scenarios are illustrated. Conclusion: Careful review of free flap failures indicates that a thorough workup (particularly coagulation disorders), flap selection, surgeon to anesthesia communication, proper securing of the flap, and postoperative patient blood pressure and infection control have a greater part to play in this new era of anastomotic success.

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The Osteocutaneous Scapular Flap for Mandibular and Maxillary Reconstruction

Cited by 627 publications

References 0 publications

Zygoma implant-supported prosthetic rehabilitation after partial maxillectomy using surgical navigation: A clinical report

Zygoma implant-supported prosthetic rehabilitation after partial maxillectomy using surgical navigation: A clinical report

Mandibular Reconstruction with Vascularized Osseous Free Flaps: a Review of the Literature

Anatomy of Free Flap Failures: Dissection of a Series

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