Sandwich flaps as a feasible solution for the management of huge mandibular composite tissue defects

J Weitz; K Kreutzer; F J M Bauer; K-D Wolff; C-P Nobis; M R Kesting

doi:10.1016/j.jcms.2015.07.038

Sandwich flaps as a feasible solution for the management of huge mandibular composite tissue defects

Standard

Sandwich flaps as a feasible solution for the management of huge mandibular composite tissue defects. / Weitz, J; Kreutzer, K; Bauer, F J M; Wolff, K-D; Nobis, C-P; Kesting, M R.

In: J CRANIO MAXILL SURG, Vol. 43, No. 9, 11.2015, p. 1769-75.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Weitz, J, Kreutzer, K, Bauer, FJM, Wolff, K-D, Nobis, C-P & Kesting, MR 2015, 'Sandwich flaps as a feasible solution for the management of huge mandibular composite tissue defects', J CRANIO MAXILL SURG, vol. 43, no. 9, pp. 1769-75. https://doi.org/10.1016/j.jcms.2015.07.038

APA

Weitz, J., Kreutzer, K., Bauer, F. J. M., Wolff, K-D., Nobis, C-P., & Kesting, M. R. (2015). Sandwich flaps as a feasible solution for the management of huge mandibular composite tissue defects. J CRANIO MAXILL SURG, 43(9), 1769-75. https://doi.org/10.1016/j.jcms.2015.07.038

Vancouver

Weitz J, Kreutzer K, Bauer FJM, Wolff K-D, Nobis C-P, Kesting MR. Sandwich flaps as a feasible solution for the management of huge mandibular composite tissue defects. J CRANIO MAXILL SURG. 2015 Nov;43(9):1769-75. https://doi.org/10.1016/j.jcms.2015.07.038

Bibtex

@article{9a46354ff5614bac8ad4d1fbc30c9921,

title = "Sandwich flaps as a feasible solution for the management of huge mandibular composite tissue defects",

abstract = "In the current therapy of head and neck defects, surgical reconstruction with the aid of pedicle or free flaps is common practice. Suitable single flaps are available to solve most reconstructive challenges. However, reconstruction can become a problem in extensive mandibular defects, as they are often caused by large primary tumors or osteoradionecrosis. These composite defects often lead to large intraoral or extraoral fistulas due to the involvement of mucosa, skin, mandible and soft tissue. These issues call for a double flap approach in order to achieve adequate reconstruction. Therefore, we developed a surgical sandwich technique as presented in this study. The procedure features the acquisition and use of two vascular flaps which can be freely combined according to their desired features (for example being of high tissue volume or osteomyocutaneous). In our study we included 11 patients (ten male, one female) with a mean age of 57 years. Seven of the patients had defects due to osteoradionecrosis and four due to tumor resection. A sandwich technique was performed in a single operation in eight patients, whereas for three patients several operations were necessary. The flaps used included: fibula free flap (FFF); anterolateral thigh (ALT); radial forearm flap (RFF); deltopectoral flap (DPF) and tensor fascia lata (TFL). The following combinations were used: FFF and ALT (three cases), FFF and RFF (two), FFF and DPF (three), ALT and TFL (two), and two ALT flaps (one). The sandwich technique proved suitable for complex reconstructions and led to desirable esthetic and functional results. The flexibility in combining different free or pedicle flaps made it possible to address various defect situations and consequently offer satisfactory surgical reconstruction for complex cases.",

author = "J Weitz and K Kreutzer and Bauer, {F J M} and K-D Wolff and C-P Nobis and Kesting, {M R}",

year = "2015",

month = nov,

doi = "10.1016/j.jcms.2015.07.038",

language = "English",

volume = "43",

pages = "1769--75",

journal = "J CRANIO MAXILL SURG",

issn = "1010-5182",

publisher = "Elsevier",

number = "9",

}

RIS

TY - JOUR

T1 - Sandwich flaps as a feasible solution for the management of huge mandibular composite tissue defects

AU - Weitz, J

AU - Kreutzer, K

AU - Bauer, F J M

AU - Wolff, K-D

AU - Nobis, C-P

AU - Kesting, M R

PY - 2015/11

Y1 - 2015/11

N2 - In the current therapy of head and neck defects, surgical reconstruction with the aid of pedicle or free flaps is common practice. Suitable single flaps are available to solve most reconstructive challenges. However, reconstruction can become a problem in extensive mandibular defects, as they are often caused by large primary tumors or osteoradionecrosis. These composite defects often lead to large intraoral or extraoral fistulas due to the involvement of mucosa, skin, mandible and soft tissue. These issues call for a double flap approach in order to achieve adequate reconstruction. Therefore, we developed a surgical sandwich technique as presented in this study. The procedure features the acquisition and use of two vascular flaps which can be freely combined according to their desired features (for example being of high tissue volume or osteomyocutaneous). In our study we included 11 patients (ten male, one female) with a mean age of 57 years. Seven of the patients had defects due to osteoradionecrosis and four due to tumor resection. A sandwich technique was performed in a single operation in eight patients, whereas for three patients several operations were necessary. The flaps used included: fibula free flap (FFF); anterolateral thigh (ALT); radial forearm flap (RFF); deltopectoral flap (DPF) and tensor fascia lata (TFL). The following combinations were used: FFF and ALT (three cases), FFF and RFF (two), FFF and DPF (three), ALT and TFL (two), and two ALT flaps (one). The sandwich technique proved suitable for complex reconstructions and led to desirable esthetic and functional results. The flexibility in combining different free or pedicle flaps made it possible to address various defect situations and consequently offer satisfactory surgical reconstruction for complex cases.

AB - In the current therapy of head and neck defects, surgical reconstruction with the aid of pedicle or free flaps is common practice. Suitable single flaps are available to solve most reconstructive challenges. However, reconstruction can become a problem in extensive mandibular defects, as they are often caused by large primary tumors or osteoradionecrosis. These composite defects often lead to large intraoral or extraoral fistulas due to the involvement of mucosa, skin, mandible and soft tissue. These issues call for a double flap approach in order to achieve adequate reconstruction. Therefore, we developed a surgical sandwich technique as presented in this study. The procedure features the acquisition and use of two vascular flaps which can be freely combined according to their desired features (for example being of high tissue volume or osteomyocutaneous). In our study we included 11 patients (ten male, one female) with a mean age of 57 years. Seven of the patients had defects due to osteoradionecrosis and four due to tumor resection. A sandwich technique was performed in a single operation in eight patients, whereas for three patients several operations were necessary. The flaps used included: fibula free flap (FFF); anterolateral thigh (ALT); radial forearm flap (RFF); deltopectoral flap (DPF) and tensor fascia lata (TFL). The following combinations were used: FFF and ALT (three cases), FFF and RFF (two), FFF and DPF (three), ALT and TFL (two), and two ALT flaps (one). The sandwich technique proved suitable for complex reconstructions and led to desirable esthetic and functional results. The flexibility in combining different free or pedicle flaps made it possible to address various defect situations and consequently offer satisfactory surgical reconstruction for complex cases.

U2 - 10.1016/j.jcms.2015.07.038

DO - 10.1016/j.jcms.2015.07.038

M3 - SCORING: Journal article

C2 - 26330301

VL - 43

SP - 1769

EP - 1775

JO - J CRANIO MAXILL SURG

JF - J CRANIO MAXILL SURG

SN - 1010-5182

IS - 9

ER -