The use of the multi-island vertical rectus abdominis myocutaneous flap in head and neck reconstruction Journal Article
| Authors: | Patel, N. P.; Matros, E.; Cordeiro, P. G. |
| Article Title: | The use of the multi-island vertical rectus abdominis myocutaneous flap in head and neck reconstruction |
| Abstract: | BACKGROUND: Head and neck cancer extirpation frequently creates complex 3-dimensional defects involving both intraoral and external tissues. Reconstruction can be accomplished either with 2 free flaps, a simultaneous free and pedicle flap, or a single double-island folded free flap. Herein, the outcomes and rationale for reconstruction of multilaminar head and neck defects using the multi-island vertical rectus abdominis myocutaneous (MI-VRAM) flap are reported. METHODS: A retrospective review was performed of a prospectively collected database of all head and neck reconstructions completed by a single surgeon between 1992 and 2011. Forty-six patients were identified who underwent reconstruction of composite defects using MI-VRAM flaps. Oncologic defects were classified into 3 categories based on anatomic location, namely, the midface, lower face, and neck. Indications and outcomes were reviewed. RESULTS: Patients' ages ranged from 7 to 84 years with two thirds being male; 45% received preoperative radiation. Average MI-VRAM skin paddle size was 9 × 25.5 cm. Of the 46 reconstructions, 27 (59%) were performed in the midface, 14 (30%) in the lower face, and 5 (11%) in the neck region. There were no complete flap loses; however, 1 patient lost the external skin island, requiring pectoralis flap coverage. Of these cases, 15% had surgically related complications. Ten patients required secondary contouring procedures to revise bulky flaps. CONCLUSIONS: The MI-VRAM flap is a safe and reliable technique for reconstruction of complex defects throughout the head and neck region. Compared to 2 simultaneous free flaps or a free flap combined with a regional flap, it saves time and eliminates a second donor site. LEVEL OF EVIDENCE: Level IV. Clinical question addressed in this paper is whether a multi-island VRAM flap is a safe technique in head and neck reconstruction. Copyright © 2012 by Lippincott Williams & Wilkins. |
| Journal Title: | Annals of Plastic Surgery |
| Volume: | 69 |
| Issue: | 4 |
| ISSN: | 0148-7043 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2012-10-01 |
| Start Page: | 403 |
| End Page: | 407 |
| Language: | English |
| DOI: | 10.1097/SAP.0b013e3182400ed8 |
| PROVIDER: | scopus |
| PUBMED: | 22868301 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 November 2012" - "CODEN: APCSD" - "Source: Scopus" |
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