Donor Site Morbidity in Patients Undergoing Maxillofacial Reconstruction Using Free Fibula Flap Versus Deep Circumflex Artery Flap-A Systematic Review.

IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE
Journal of Maxillofacial & Oral Surgery Pub Date : 2024-06-01 Epub Date: 2022-03-07 DOI:10.1007/s12663-022-01698-2
Sanika S Tidke, Pushkar P Waknis, Sneha Setiya, Kunal M Jain, Deeisha Gupta, Samkit Sakhariya
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引用次数: 0

Abstract

Introduction: A systematic review of the literature on the donor site morbidity in patients undergoing Maxillofacial reconstruction was performed. The two widely used flaps namely free fibula flap (FFF) and DCIA flap were compared to answer the following questions: (1) Is donor site morbidity significantly different in patients undergoing maxillofacial reconstruction with FFF and DCIA flap? (2) Should donor site morbidity be considered as the criteria for choosing the flap for reconstruction.

Materials and methods: The search strategy was based on PRISMA guidelines. Various electronic databases were searched. On reviewing the seven articles included in our systematic review, we found out oral squamous cell carcinoma to be the most common pathology leading to the defects in head and neck region requiring reconstruction with free flaps.

Results: A total of 531 participants were investigated who underwent maxillofacial reconstruction using FFF and DCIA flap. The study included both the genders. The participants were assessed for short- and long-term donor site morbidity after the microvascular surgery. Mean age is 45-60 years. Three out of seven studies showed DCIA to have lesser complications at donor site than fibula group. While other two studies proved FFF to be better than DCIA. One study proved low donor site morbidity with regard to both the flap.

Conclusion: The free fibula being the flap of choice in head and neck reconstruction has a comparable donor site morbidity to DCIA. The advantages of the iliac artery flap include natural curvature, abundant vertical and horizontal bone height for bone contouring and osseointegration, hidden scar, low incidence of wound healing problems and minimal effect on function and quality of life at long-term follow-up. Thus, it makes it the free flap of choice that one cannot avoid. This systematic review was registered at PROSPERO (CRD42021268949).

游离腓骨皮瓣与深旋动脉皮瓣颌面部重建患者供区发病率的比较——系统综述
导言:我们对有关颌面部重建患者供体部位发病率的文献进行了系统回顾。比较了两种广泛使用的皮瓣,即游离腓骨瓣(FFF)和DCIA皮瓣,以回答以下问题:(1)使用游离腓骨瓣和DCIA皮瓣进行颌面部重建的患者的供体部位发病率是否有显著差异? 2)供体部位发病率是否应作为选择皮瓣进行重建的标准:检索策略基于 PRISMA 指南。材料:检索策略基于 PRISMA 指南,检索了多个电子数据库。在对纳入系统综述的七篇文章进行审查后,我们发现口腔鳞状细胞癌是导致头颈部缺损、需要使用游离皮瓣进行重建的最常见病理:共有 531 人接受了使用 FFF 和 DCIA 皮瓣进行的颌面部重建手术。研究对象包括男性和女性。研究人员对微血管手术后供体部位的短期和长期发病率进行了评估。平均年龄为 45-60 岁。七项研究中有三项显示,DCIA供体部位的并发症少于腓骨组。另外两项研究则证明腓骨移植优于腓骨置换术。一项研究证明,两种皮瓣的供体部位发病率都较低:结论:游离腓骨是头颈部重建的首选皮瓣,其供体部位发病率与DCIA相当。髂动脉皮瓣的优点包括:自然的弧度、丰富的垂直和水平骨高,有利于骨塑形和骨整合、疤痕隐蔽、伤口愈合问题发生率低、长期随访时对功能和生活质量的影响极小。因此,它是无法回避的首选游离皮瓣。本系统综述已在 PROSPERO 注册(CRD42021268949)。
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来源期刊
Journal of Maxillofacial & Oral Surgery
Journal of Maxillofacial & Oral Surgery DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
1.90
自引率
0.00%
发文量
138
期刊介绍: This journal offers comprehensive coverage of new techniques, important developments and innovative ideas in Oral and Maxillofacial Surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments, diagnostic equipment’s and modern therapeutic drugs and devices. Journal of Oral and Maxillofacial Surgery is recommended for first or priority subscription by the Dental Section of the Medical Library Association. Specific topics covered recently have included: ? distraction osteogenesis ? synthetic bone substitutes ? fibroblast growth factors ? fetal wound healing ? skull base surgery ? computer-assisted surgery ? vascularized bone grafts Benefits to authorsWe also provide many author benefits, such as free PDFs, a liberal copyright policy, special discounts on Elsevier publications and much more. Please click here for more information on our author services.
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