Submental island flap vs free tissue transfer in oral cavity reconstruction: Systematic review and meta‐analysis

Head & Neck ◽  
2020 ◽  
Vol 42 (8) ◽  
pp. 2155-2164 ◽  
Author(s):  
Shirley Hu ◽  
Caleb Fan ◽  
Brandon Pecchia ◽  
Joshua D. Rosenberg
Keyword(s):  
Systematic Review ◽  
Oral Cavity ◽  
Meta Analysis ◽  
Free Tissue Transfer ◽  
Island Flap ◽  
Tissue Transfer ◽  
Oral Cavity Reconstruction ◽  
Submental Island Flap

Submental Island Flap After Prior Contralateral Neck Dissection: A Case Series and Technical Considerations

2021 ◽  
pp. 000348942110593
Author(s):  
Andrew R. Larson ◽  
Nicholas B. Abt ◽  
Daniel G. Deschler
Keyword(s):  
Oral Cavity ◽  
Neck Dissection ◽  
Case Series ◽  
Island Flap ◽  
Head And Neck Reconstruction ◽  
Skin Paddle ◽  
Oral Cavity Reconstruction ◽  
Surgical Setting ◽  
Submental Island Flap ◽  
Technical Considerations

Objectives: The submental island flap is a dependable workhorse in head and neck reconstruction. However, the viability of this flap has not been established for oral cavity reconstruction when a contralateral neck dissection has already been performed in an earlier surgical setting. The aim of this study is to highlight technical considerations and outcomes of this approach with a small case series. Methods: Three cases of oral cavity reconstruction with a submental island flap elevated in the context of a prior contralateral neck dissection are presented. Results: In all cases, a doppler was used to identify the maintenance of the submental perforator in the neck opposite the previous neck dissection. In 2 cases, level IA was included within the dissection field of the previous neck dissection. Additionally, the old neck scar was included within the skin paddle of the submental island flap in 2 cases. In all cases, excellent healing of the flap was observed without partial or complete loss. Conclusions: The submental island flap appears to be a reliable reconstruction when a previous contralateral neck dissection has been performed, even when level IA was included in the prior dissection.

scholarly journals Free Tissue Transfer in Pressure Ulcer Reconstruction: A Systematic Review

2021 ◽  
Vol 06 (01) ◽  
pp. e35-e39
Author(s):  
Chelsi Robertson ◽  
Charles Patterson ◽  
Hugo St. Hilaire ◽  
Frank H. Lau
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Final Analysis ◽  
The United States ◽  
Local Flap ◽  
Recurrence Rates ◽  
Tissue Transfer ◽  
Cochrane Database

Abstract Background Pressure ulcers (PUs) affect 2.5 million people in the United States annually and incur health-care costs of 11 billion dollars annually. Stage III/IV PU often require local flap reconstruction. Unfortunately, PU recurrence is common following reconstruction; recurrence rates as high as 82% have been reported. When local flap options are inadequate, free tissue transfer may be indicated but the indications have yet to be delineated. To develop evidence-based guidelines for the use of free flaps in PU reconstruction, we performed a systematic review. Methods A systematic review of the available English-language, peer-reviewed literature was conducted using PubMed/MEDLINE, Google Scholar, Scopus, EMBASE, and the Cochrane Database of Systematic Reviews. Articles were manually reviewed for relevance. Results Out of 272 articles identified, 10 articles were included in the final analysis. Overall, this systematic review suggests that free-flap PU reconstruction yields fewer recurrences compared with local flaps (0–20 vs. 13–82%). Further, several types of free flaps for PU reconstruction were identified in this review, along with their indications. Conclusion Free tissue transfer should be considered for recurrent PU. We offer specific recommendations for their use in PU reconstruction.

P202. Submental island flap for reconstruction of oral cavity and oropharynx

Oral Oncology ◽  
2011 ◽  
Vol 47 ◽  
pp. S139
Author(s):  
S. Song ◽  
Y. Kim ◽  
C. Bae ◽  
S. Ye ◽  
B. Jeon
Keyword(s):  
Oral Cavity ◽  
Island Flap ◽  
Submental Island Flap

The Effect of Perforator Skeletonization on Pedicled Fasciocutaneous Flaps of the Lower Extremity: A Systematic Review

2020 ◽  
Vol 36 (09) ◽  
pp. 634-644
Author(s):  
Carol E. Soteropulos ◽  
Nikita O. Shulzhenko ◽  
Harry S. Nayar ◽  
Samuel O. Poore
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Complication Rate ◽  
Perforator Flap ◽  
Free Tissue Transfer ◽  
Cochrane Central Register ◽  
Fasciocutaneous Flaps ◽  
Tissue Transfer ◽  
Individual Participant ◽  
The Impact

Abstract Background Lower extremity defects often require free tissue transfer due to a paucity of local donor sites. Locoregional perforator-based flaps offer durable, single-stage reconstruction while avoiding the pitfalls of microsurgery. Multiple harvest techniques are described, yet few studies provide outcome comparisons. Specifically, no study has examined the impact of perforator flap pedicle skeletonization on reconstructive outcomes. This systematic review characterizes technique and impact of pedicle skeletonization on perforator-based fasciocutaneous flaps of the lower extremity. Methods PubMed, Scopus, and the Cochrane Central Register of Controlled Trials were reviewed for literature examining perforator-based fasciocutaneous flaps from knee to ankle, from January 2000 through November 2018. The Preferred Reporting Items for Systematic Reviews-Individual Participant Data (PRISMA-IPD) structure was used. Results Thirty-six articles were included for quantitative analysis. Of 586 flaps, 365 were skeletonized (60.1%) with 58 major (9.9%) and 19 minor complications (3.2%). With skeletonization, overall reoperative rate was higher (odds ratio [OR]: 9.71, p = 0.004), specifically in propeller (OR: 12.50, p = 0.004) and rotational flaps (OR: 18.87, p = 0.004). The complication rate of rotational flaps also increased (OR: 2.60, p = 0.04). Notably, skeletonization reduced complications in flaps rotated 90 degrees or more (OR: 0.21, p = 0.02). Reoperative rate of distal third defects (OR: 14.08, p = 0.02), flaps over 48 cm2 (OR: 33.33, p = 0.01), and length to width ratios over 1.75 (OR: 7.52, p = 0.03) was increased with skeletonization. Skeletonization increased complications in traumatic defects (OR: 2.87, p = 0.04) and reduced complications in malignant defects (OR: 0.10, p = 0.01). Conclusion Pedicled, perforator-based flaps can provide a reliable locoregional alternative to free tissue transfer for lower extremity defects. Though skeletonization increased the overall reoperative rate, the complication rate for flaps with 90 degrees or more of rotation was significantly reduced. This suggests skeletonization should be considered when large rotational movements are anticipated to reduce complications that can arise from pedicle compression and venous congestion.

O175. Metastases to level IIb in squamous cell carcinoma of the oral cavity: A systematic review and meta-analysis

2009 ◽  
Vol 3 (1) ◽  
pp. 114
Author(s):  
J. Lea ◽  
G. Bachar ◽  
A. Sawka ◽  
D.C. Lakra ◽  
R.W. Gilbert ◽  
...  
Keyword(s):  
Systematic Review ◽  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Meta Analysis
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