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Year : 2012  |  Volume : 8  |  Issue : 1  |  Page : 91-95

Reconstruction of oncological oro-mandibular defects with double skin paddled-free fibula flap: A prudent alternative to double flaps in resource-constrained centres

Plastic and Reconstructive Services, TATA Memorial Hospital, Mumbai, India

Correspondence Address:
G I Nambi
Plastic and Reconstructive Microvascular Services, Comprehensive Cancer Center, K.M.C.H., Coimbatore, Tamilnadu - 641014
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0973-1482.95181

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Objective: The free fibula flap is the choice flap for mandibular reconstruction following extensive tumor resections. While large defects are managed with a second flap [free or pedicle] in advanced centres, a free fibula flap with a large skin paddle that can be de-epithelised to provide outer skin and inner lining is the best alternative in resource- constrained centres. Materials and Methods: From January 2005 to December 2009 a total of 386 free fibula flaps were used of which 307 flaps had de-epithelised double skin paddle in reconstructing complex oral and mandibular defects after tumor ablative surgeries. Results: Complete flap survival was seen in 282/307 patients. Complete flap loss was seen in 9/307 patients. Partial flap loss was seen in 16 patients. Re - exploration was done in 30 patients and the flap was salvaged in 21 patients. Conclusion: The vascular supply of the free fibula osteo myocutaneous flap is reliable and a flap with a large skin paddle can be used to provide both inner lining and outer cover in resource-constrained centres.

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