Use of modified lateral upper arm free flap for reconstruction of soft tissue defect after resection of oral cancer

Abstract

Background: To evaluate the suitability of a modified lateral upper arm free flap (LAFF) for reconstruction of soft tissue defects after resection of oral cancer. Methods: Eighteen cases of soft tissue defect repair performed between January 2011 and December 2013 using a modified LAFF after resection of oral cancer were reviewed. The design and harvest of the LAFF, the reconstruction procedure, and postoperative morbidity were reviewed and evaluated over a follow-up period of at least 12 months. Results: The overall flap survival was 94.4 % (17/18 patients). A broad scar at the donor site was the most common morbidity, but patients did not report dissatisfaction with the scar because they could easily cover it. All wounds at the donor site achieved primary recovery. One case of flap loss was repaired with a radial forearm free flap. One case complicated by diabetes mellitus involved infection of the flap with one-third of the flap becoming necrotic. This flap survived after removal of the necrotic tissue. In one other case, fat liquefactive necrosis (1.5 × 1.0 cm) occurred in the flap on the tip of the tongue, and this flap survived after debridement. Overall, the shape and function of the reconstructed tissues were well restored, and there was no severe morbidity at the donor site in any case. Conclusion: The modified LAFF was safe and reliable for the reconstruction of soft tissue defects after resection of oral cancer.

Versatility and outcomes of lateral arm free flap in head and neck reconstruction: a retrospective case series study of our experiences and innovations

“…The most notable drawback is its short vascular pedicle and thin blood vessel diameter. 16 To address this issue, Wang et al proposed a modification to the technique by cutting off the blood vessel at the level of the deep brachial artery, resulting in a longer and wider anastomosing artery. 17 This modification, known as modified LAFF (mLAFF), has shown promising outcomes with minimal donor site complications, thereby enhancing the potential of LAFF in head and neck reconstruction.…”

Repair of postoperative defects of oral cancer with submental island flaps based on vascular pedicles of different states: a multicenter retrospective study

“…Tissue flap repair and reconstruction technology play an important role in extended tumor resection, postoperative reconstruction, restoration of oral function, alleviation of physiological, psychological and social impact, and improving quality of life. With the development of head and neck functional surgery, a consensus has been attained on the immediate postoperative repair and reconstruction of oral cancer that free flap can achieve satisfactory appearance reconstruction and functional recovery, and is the primary means for repairing postoperative defects of oral cancer [8][9][10]18 . The high-level technique required for preparation of free flap, the delicate and complicated operation of microvascular anastomosis, the long operation time, the high risk if a vascular crisis occurs, and the perioperative nursing have limited the wide application of free flap 19,20 .…”