Outcomes after free tissue transfer for composite oral cavity resections involving skin
Background Resections involving oral cavity mucosa, bone, and skin present a unique challenge. Optimizing outcomes often requires technically demanding reconstruction. The purpose of this study is to evaluate outcomes of several reconstructive approaches for patients with composite through‐and‐throu...
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| Veröffentlicht in: | Head & neck 2018-05, Vol.40 (5), p.973-984 |
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| container_title | Head & neck |
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| creator | Alvi, Sameer A. Hamill, Chelsea S. Lepse, Jason P. Ayala, Marco Girod, Douglas A. Tsue, Terance T. Shnayder, Yelizaveta Kakarala, Kiran |
| description | Background
Resections involving oral cavity mucosa, bone, and skin present a unique challenge. Optimizing outcomes often requires technically demanding reconstruction. The purpose of this study is to evaluate outcomes of several reconstructive approaches for patients with composite through‐and‐through defects, with a focus on the osteocutaneous radial forearm free flap (RFFF).
Methods
We conducted a retrospective evaluation of the cohort of patients treated for composite through‐and‐through defects with cutaneous involvement who underwent free flap reconstruction from August 2012 through October 2015.
Results
Seventeen patients received a single flap (12 cases of osteocutaneous RFFF), whereas 10 patients underwent a combination of flaps. Complication rates and functional outcomes were favorable in patients who underwent osteocutaneous RFFFs. The supraclavicular artery island flap (SCAIF) was used as a second flap in 3 cases.
Conclusion
The osteocutaneous RFFF provides a valuable reconstructive option for complex composite resection defects involving skin. When 2 flaps are required, the SCAIF is a viable alternative to a second free flap or pectoralis flap. |
| doi_str_mv | 10.1002/hed.25062 |
| format | Article |
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Resections involving oral cavity mucosa, bone, and skin present a unique challenge. Optimizing outcomes often requires technically demanding reconstruction. The purpose of this study is to evaluate outcomes of several reconstructive approaches for patients with composite through‐and‐through defects, with a focus on the osteocutaneous radial forearm free flap (RFFF).
Methods
We conducted a retrospective evaluation of the cohort of patients treated for composite through‐and‐through defects with cutaneous involvement who underwent free flap reconstruction from August 2012 through October 2015.
Results
Seventeen patients received a single flap (12 cases of osteocutaneous RFFF), whereas 10 patients underwent a combination of flaps. Complication rates and functional outcomes were favorable in patients who underwent osteocutaneous RFFFs. The supraclavicular artery island flap (SCAIF) was used as a second flap in 3 cases.
Conclusion
The osteocutaneous RFFF provides a valuable reconstructive option for complex composite resection defects involving skin. When 2 flaps are required, the SCAIF is a viable alternative to a second free flap or pectoralis flap.</description><identifier>ISSN: 1043-3074</identifier><identifier>EISSN: 1097-0347</identifier><identifier>DOI: 10.1002/hed.25062</identifier><identifier>PMID: 29360278</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Carcinoma, Basal Cell - pathology ; Carcinoma, Basal Cell - surgery ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - surgery ; Clavicle ; composite resection ; Defects ; Female ; Forearm ; free flap reconstruction ; Free Tissue Flaps ; Graft Survival ; Head & neck cancer ; Head and neck ; head and neck cancer ; Humans ; Male ; Mandible ; microvascular reconstruction ; Middle Aged ; Mouth Neoplasms - pathology ; Mouth Neoplasms - surgery ; Mucosa ; Oral cavity ; oral cavity cancer ; osteocutaneous radial forearm free flap ; Osteoradionecrosis - pathology ; Osteoradionecrosis - surgery ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin ; Treatment Outcome</subject><ispartof>Head & neck, 2018-05, Vol.40 (5), p.973-984</ispartof><rights>2018 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3532-df79bcda1d06e079847d0787bf3e1396efdf2c6d9d7cdfcb9d33dbf07e473aa93</citedby><cites>FETCH-LOGICAL-c3532-df79bcda1d06e079847d0787bf3e1396efdf2c6d9d7cdfcb9d33dbf07e473aa93</cites><orcidid>0000-0002-9313-3376 ; 0000-0003-3902-1346</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhed.25062$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhed.25062$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29360278$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alvi, Sameer A.</creatorcontrib><creatorcontrib>Hamill, Chelsea S.</creatorcontrib><creatorcontrib>Lepse, Jason P.</creatorcontrib><creatorcontrib>Ayala, Marco</creatorcontrib><creatorcontrib>Girod, Douglas A.</creatorcontrib><creatorcontrib>Tsue, Terance T.</creatorcontrib><creatorcontrib>Shnayder, Yelizaveta</creatorcontrib><creatorcontrib>Kakarala, Kiran</creatorcontrib><title>Outcomes after free tissue transfer for composite oral cavity resections involving skin</title><title>Head & neck</title><addtitle>Head Neck</addtitle><description>Background
Resections involving oral cavity mucosa, bone, and skin present a unique challenge. Optimizing outcomes often requires technically demanding reconstruction. The purpose of this study is to evaluate outcomes of several reconstructive approaches for patients with composite through‐and‐through defects, with a focus on the osteocutaneous radial forearm free flap (RFFF).
Methods
We conducted a retrospective evaluation of the cohort of patients treated for composite through‐and‐through defects with cutaneous involvement who underwent free flap reconstruction from August 2012 through October 2015.
Results
Seventeen patients received a single flap (12 cases of osteocutaneous RFFF), whereas 10 patients underwent a combination of flaps. Complication rates and functional outcomes were favorable in patients who underwent osteocutaneous RFFFs. The supraclavicular artery island flap (SCAIF) was used as a second flap in 3 cases.
Conclusion
The osteocutaneous RFFF provides a valuable reconstructive option for complex composite resection defects involving skin. When 2 flaps are required, the SCAIF is a viable alternative to a second free flap or pectoralis flap.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Basal Cell - pathology</subject><subject>Carcinoma, Basal Cell - surgery</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Clavicle</subject><subject>composite resection</subject><subject>Defects</subject><subject>Female</subject><subject>Forearm</subject><subject>free flap reconstruction</subject><subject>Free Tissue Flaps</subject><subject>Graft Survival</subject><subject>Head & neck cancer</subject><subject>Head and neck</subject><subject>head and neck cancer</subject><subject>Humans</subject><subject>Male</subject><subject>Mandible</subject><subject>microvascular reconstruction</subject><subject>Middle Aged</subject><subject>Mouth Neoplasms - pathology</subject><subject>Mouth Neoplasms - surgery</subject><subject>Mucosa</subject><subject>Oral cavity</subject><subject>oral cavity cancer</subject><subject>osteocutaneous radial forearm free flap</subject><subject>Osteoradionecrosis - pathology</subject><subject>Osteoradionecrosis - surgery</subject><subject>Reconstructive Surgical Procedures</subject><subject>Retrospective Studies</subject><subject>Skin</subject><subject>Treatment Outcome</subject><issn>1043-3074</issn><issn>1097-0347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1LHTEUhkNp8asu-gck0I0uRk-ScZIsi58FwY3SZcgkJ2107uQ2mbly_725Xt0UunoPLw8vh4eQbwxOGQA_-4P-lJ9Dxz-RPQZaNiBa-Xlzt6IRINtdsl_KEwCIruU7ZJdr0QGXao_8up8nlxZYqA0TZhoyIp1iKXONbMcSNmXKtELLVOKENGU7UGdXcVrTjAXdFNNYaBxXaVjF8Tctz3H8Sr4EOxQ8fM8D8nh99XBx29zd3_y8-HHXOHEueOOD1L3zlnnoEKRWrfQgleyDQCZ0h8EH7jqvvXQ-uF57IXwfQGIrhbVaHJDj7e4yp78zlsksYnE4DHbENBfDtIZWKcVYRb__gz6lOY_1O8OBKyWqH1Wpky3lciolYzDLHBc2rw0Ds7Ftqm3zZruyR--Lc7-o7Qf5obcCZ1vgJQ64_v-Sub263E6-Akkpijw</recordid><startdate>201805</startdate><enddate>201805</enddate><creator>Alvi, Sameer A.</creator><creator>Hamill, Chelsea S.</creator><creator>Lepse, Jason P.</creator><creator>Ayala, Marco</creator><creator>Girod, Douglas A.</creator><creator>Tsue, Terance T.</creator><creator>Shnayder, Yelizaveta</creator><creator>Kakarala, Kiran</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9313-3376</orcidid><orcidid>https://orcid.org/0000-0003-3902-1346</orcidid></search><sort><creationdate>201805</creationdate><title>Outcomes after free tissue transfer for composite oral cavity resections involving skin</title><author>Alvi, Sameer A. ; Hamill, Chelsea S. ; Lepse, Jason P. ; Ayala, Marco ; Girod, Douglas A. ; Tsue, Terance T. ; Shnayder, Yelizaveta ; Kakarala, Kiran</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3532-df79bcda1d06e079847d0787bf3e1396efdf2c6d9d7cdfcb9d33dbf07e473aa93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Basal Cell - pathology</topic><topic>Carcinoma, Basal Cell - surgery</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Clavicle</topic><topic>composite resection</topic><topic>Defects</topic><topic>Female</topic><topic>Forearm</topic><topic>free flap reconstruction</topic><topic>Free Tissue Flaps</topic><topic>Graft Survival</topic><topic>Head & neck cancer</topic><topic>Head and neck</topic><topic>head and neck cancer</topic><topic>Humans</topic><topic>Male</topic><topic>Mandible</topic><topic>microvascular reconstruction</topic><topic>Middle Aged</topic><topic>Mouth Neoplasms - pathology</topic><topic>Mouth Neoplasms - surgery</topic><topic>Mucosa</topic><topic>Oral cavity</topic><topic>oral cavity cancer</topic><topic>osteocutaneous radial forearm free flap</topic><topic>Osteoradionecrosis - pathology</topic><topic>Osteoradionecrosis - surgery</topic><topic>Reconstructive Surgical Procedures</topic><topic>Retrospective Studies</topic><topic>Skin</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alvi, Sameer A.</creatorcontrib><creatorcontrib>Hamill, Chelsea S.</creatorcontrib><creatorcontrib>Lepse, Jason P.</creatorcontrib><creatorcontrib>Ayala, Marco</creatorcontrib><creatorcontrib>Girod, Douglas A.</creatorcontrib><creatorcontrib>Tsue, Terance T.</creatorcontrib><creatorcontrib>Shnayder, Yelizaveta</creatorcontrib><creatorcontrib>Kakarala, Kiran</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Head & neck</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alvi, Sameer A.</au><au>Hamill, Chelsea S.</au><au>Lepse, Jason P.</au><au>Ayala, Marco</au><au>Girod, Douglas A.</au><au>Tsue, Terance T.</au><au>Shnayder, Yelizaveta</au><au>Kakarala, Kiran</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes after free tissue transfer for composite oral cavity resections involving skin</atitle><jtitle>Head & neck</jtitle><addtitle>Head Neck</addtitle><date>2018-05</date><risdate>2018</risdate><volume>40</volume><issue>5</issue><spage>973</spage><epage>984</epage><pages>973-984</pages><issn>1043-3074</issn><eissn>1097-0347</eissn><abstract>Background
Resections involving oral cavity mucosa, bone, and skin present a unique challenge. Optimizing outcomes often requires technically demanding reconstruction. The purpose of this study is to evaluate outcomes of several reconstructive approaches for patients with composite through‐and‐through defects, with a focus on the osteocutaneous radial forearm free flap (RFFF).
Methods
We conducted a retrospective evaluation of the cohort of patients treated for composite through‐and‐through defects with cutaneous involvement who underwent free flap reconstruction from August 2012 through October 2015.
Results
Seventeen patients received a single flap (12 cases of osteocutaneous RFFF), whereas 10 patients underwent a combination of flaps. Complication rates and functional outcomes were favorable in patients who underwent osteocutaneous RFFFs. The supraclavicular artery island flap (SCAIF) was used as a second flap in 3 cases.
Conclusion
The osteocutaneous RFFF provides a valuable reconstructive option for complex composite resection defects involving skin. When 2 flaps are required, the SCAIF is a viable alternative to a second free flap or pectoralis flap.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29360278</pmid><doi>10.1002/hed.25062</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-9313-3376</orcidid><orcidid>https://orcid.org/0000-0003-3902-1346</orcidid></addata></record> |
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| ispartof | Head & neck, 2018-05, Vol.40 (5), p.973-984 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Aged Aged, 80 and over Carcinoma, Basal Cell - pathology Carcinoma, Basal Cell - surgery Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery Clavicle composite resection Defects Female Forearm free flap reconstruction Free Tissue Flaps Graft Survival Head & neck cancer Head and neck head and neck cancer Humans Male Mandible microvascular reconstruction Middle Aged Mouth Neoplasms - pathology Mouth Neoplasms - surgery Mucosa Oral cavity oral cavity cancer osteocutaneous radial forearm free flap Osteoradionecrosis - pathology Osteoradionecrosis - surgery Reconstructive Surgical Procedures Retrospective Studies Skin Treatment Outcome |
| title | Outcomes after free tissue transfer for composite oral cavity resections involving skin |
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