M. Ao et al., COMBINED ANTERIOR THIGH FLAPS AND VASCULARIZED FIBULAR GRAFT FOR RECONSTRUCTION OF MASSIVE COMPOSITE OROMANDIBULAR DEFECTS, British Journal of Plastic Surgery, 51(5), 1998, pp. 350-355
Six massive, composite oromandibular defects were reconstructed using
combined anterior (anterolateral and anteromedial) thigh flaps and vas
cularised fibular graft in bridge or chimeric fashion. Except for mino
r dehiscence in one case and infection in another, all flaps survived
without complication. Anterior thigh flaps provide large-calibre, long
vascular pedicles while derivative branches from the lateral circumfl
ex femoral system facilitate simultaneous transplantation of multiple
components. Because the pedicle of the vascularised fibular graft is o
f insufficient length, the lateral circumflex femoral vessels provide
a remote vascular source as a flow-through vascular conduit. A combine
d flap using the lateral circumflex femoral system is considered to be
most suitable for reconstruction of through-and-through defects of th
e head and neck. The authors describe the advantages of this method an
d the detailed anatomy of the cutaneous perforators of the anterior th
igh flaps.