Double-paddle peroneal tissue transfer for oromandibular reconstruction

The double-paddle peroneal tissue transfer is a useful technique for recons tructing the extensive and complex defect that results after ablative surge ry for oral cancer. It can facilitate the design and inset of the skin padd le and avoid the need for a second free flap. The two skin paddles can be b ased on either two cutaneous perforators of the peroneal vessels or two bra nches of a single cutaneous perforator. The authors report their experience with double-paddle peroneal tissue flap s (10 fasciocutaneous and five osteocutaneous) in 15 patients. The largest double paddle used was (16 X 9)(15 X 6) cm, and the smallest one was (7 x 5 .5)(4.5 x 4) cm. All flaps were used for both intraoral and extraoral defec t reconstruction. There was one single skin paddle necrosis caused by erron eous manipulation of the flap 1 week after the operation; however, the skin paddle had survived completely before the manipulation. All other flaps su rvived completely, with a good to excellent appearance, and no patient had a significant gait disturbance after the operation.