Pedicled Flaps for Reconstruction of Head and Neck Region

Česká verzia

Authors: Richard Pink ¹; Zdeněk Dvořák ^1,2; Petr Heinz ¹; Petr Michl ¹; Petr Tvrdý ¹; Bsel Azar ¹
Authors place of work: Klinika ústní, čelistní a obličejové chirurgie LF UP a FN Olomouc ¹; Klinika plastické a estetické chirurgie LF MU a FN u sv. Anny v Brně ²
Published in the journal: Klin Onkol 2018; 31(1): 59-65
Category: Kazuistika
doi: https://doi.org/10.14735/amko201859

Summary

Background:
There has been a consistent increase in the number of publications on pedicled flaps for the reconstruction of post ablation defects in the oropharyngeal area. In principle, tissue is lifted from a donor site and moved to a recipient site without disruption of blood supply. The donor site is an exact anatomically defined region of tissue that is capable of sustaining its own blood supply. The benefits of pedicled flaps include lower technical demands that obviate the need for microsurgical anastomosis and shorter operating times. For this reason, they are mostly indicated in elderly and at risk patients. The aim of this paper is to describe our experience with the regional (pedicled) (submental, supraclavicular) flaps with a focus on reliability, function, cosmesis, donor site morbidity, and oncological safety.

Material and Methods:
Reconstructive techniques using distal flaps are described in 12 patients. A submental flap for reconstruction was used in 7 patients. In 5 patients, we used the supraclavicular flap. A total of 9 patients were treated primarily for squamous cell carcinoma of the orofacial region, and 3 for low-grade adenocarcinoma of the small salivary gland.

Results:
In 5 patients, there was successful engraftment of the submental flap. Ischemia and necrosis of the edges of the flap occurred in 1 case. In one patient, the 3^rd day after surgery, the flap was almost totally necrotised. The supraclavicular flap in 4 patiets healed completely, 1 time during the postoperative period it was infected with partial loss of the outer part of the flap from the pre auricular region. In one case there was necrosis of the terminal part of the flap in the reconstructed part of the tongue, the defect was healed by granulation tissue. In all patients, after reconstruction using supraclavicular and submental flaps, the donor site closed primarily with minimal morbidity.

Conclusion:
Regional (pedicled) flaps are thin, and pliable with good cosmetic and functional results. Reconstruction using these flaps can be accomplished in one-stage with minimum morbidity of the donor site.

Key words:
pedicled flap – surgical flap – head and neck cancers

Submitted:
11. 5. 2017

Accepted:
5. 11. 2017

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Zdroje

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