Search Our Scientific Publications & Authors

Microsurgery 2019 Jan 15. Epub 2019 Jan 15.

Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Background: With the rising number of patients in advanced age receiving microsurgical procedures, coronary artery disease (CAD) and its challenging management is of increasing importance. Evidence based data concerning morbidity and mortality are rare. We present our experiences with this highly selected patient population and propose a preoperative assessment algorithm. Read More

Neurochirurgie 2018 Dec 19;64(6):434-438. Epub 2018 Sep 19.

Department of Neurosurgery, La Timone Hospital, 13005 Marseille, France. Electronic address:

The case under review is a 60-year-old patient with a vertebral plasmocytoma treated by cervico-thoracic fusion 2 years previously. He presented a thoracic spinal septic non-union complicated by esophagospinal fistula. We performed vascularized fibula transplant with cutaneous pad to fill the esophageal fistula. Read More

J Plast Reconstr Aesthet Surg 2018 Dec 24;71(12):1730-1739. Epub 2018 Aug 24.

Division of Orthopaedics and Traumatology, Unit of Musculoskeletal Surgery, Tampere University Hospital, Tampere, Finland; Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Helsinki, Finland.

Background: Sacrectomy is a rare and demanding surgical procedure that results in major soft tissue defects and spinopelvic discontinuity. No consensus is available on the optimal reconstruction algorithm. Therefore, the present study evaluated the results of sacrectomy reconstruction and its impact on patients' quality of life (QOL). Read More

J Pediatr Orthop B 2018 Sep 25. Epub 2018 Sep 25.

Pediatric Orthopaedic Unit, Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu, India.

We describe a technique for optimal use of fibula in reconstruction of type II tibial hemimelia. Six affected children with mean age of 1.4 years and treated over a 5-year period were reviewed. Read More

NMR Biomed 2018 Nov 30;31(11):e3994. Epub 2018 Jul 30.

Department of Radiology, University of California, San Diego, California.

Bone stress injury (BSI) incidents have been increasing amongst athletes in recent years as a result of more intense sporting activities. Cortical bone in the tibia and fibula is one of the most common BSI sites. Nowadays, clinical magnetic resonance imaging (MRI) is the recommended technique for BSI diagnosis at an early stage. Read More

Otolaryngol Head Neck Surg 2018 Jul 1:194599818789132. Epub 2018 Jul 1.

1 Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Objective This study evaluated the accuracy of the Surgical Risk Calculator (SRC) of the ACS NSQIP (American College of Surgeons National Surgical Quality Improvement Program) in predicting head and neck microvascular reconstruction outcomes. Study Design Retrospective analysis. Setting Tertiary medical center. Read More

Am J Otolaryngol 2018 Sep - Oct;39(5):558-560. Epub 2018 Jun 18.

Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX, USA. Electronic address:

Introduction: In this study, we explore whether preoperative external beam radiation affects complication rates in patients that have undergone double simultaneous free tissue transfer for head and neck defects.

Study Design, Setting, Subjects And Methods: Approval was obtained from the JPS Institutional Review Board. We performed a retrospective analysis of patients who underwent double free flap reconstruction of head and neck defects between August 1997 and April 2017. Read More

J Craniomaxillofac Surg 2018 Aug 5;46(8):1205-1210. Epub 2018 Jun 5.

Private Practise MKG am Theater, Neuenweg16, 35390, Giessen, Germany.

Purpose: Ablative oncological surgery to treat head-and-neck cancer often triggers a requirement for jaw reconstruction. Modern surgical procedures using free microvascular flaps afford acceptable outcomes in terms of restoration of bony and soft tissue defects. A fibula free flap is often the preferred flap, as the bone length is considerable and a two-surgeon approach is possible. Read More

JAMA Facial Plast Surg 2018 Sep;20(5):401-408

Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota.

Importance: The clinical and financial implications of the timing of dental rehabilitation after a fibula free tissue transfer (FFTT) for osteoradionecrosis (ORN) and osteonecrosis (ON) of the mandible have yet to be established.

Objective: To compare the outcomes of primary implantation vs secondary implantation after FFTT for ORN and ON of the mandible.

Design, Setting, And Participants: A retrospective review was conducted of 23 patients at a single tertiary academic referral center undergoing primary implantation or secondary implantation after FFTT for ORN and ON from January 1, 2006, to November 10, 2015. Read More

J Reconstr Microsurg 2018 Oct 18;34(8):590-600. Epub 2018 May 18.

Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kansas.

Background:  Microvascular reconstruction of the anterior cranial fossa (ACF) creates difficult challenges. Reconstructive goals and flap selection vary based on the defect location within the ACF. This study evaluates the feasibility and reliability of free tissue transfer for salvage reconstruction of low, middle, and high ACF defects. Read More

J Reconstr Microsurg 2018 Nov 12;34(9):719-728. Epub 2018 May 12.

Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.

Background:  The superficial circumflex iliac artery (SCIA)-based iliac bone flap has yet to be widely used. The purpose of this article is to validate the feasibility of SCIA-based iliac bone flap transfers for reconstruction of small to moderate-sized bony defects. Retrospective outcome comparisons between SCIA-based iliac bone flaps and fibula flaps were made. Read More

Microsurgery 2018 May 7. Epub 2018 May 7.

Division of Plastic and Reconstructive Surgery, Mayo Clinic Hospital, Phoenix, Arizona.

Early soft-tissue coverage is critical for treating traumatic open lower-extremity wounds. As free-flap reconstruction evolves, injuries once thought to be nonreconstructable are being salvaged. Free-tissue transfer is imperative when there is extensive dead space or exposure of vital structures such as bone, tendon, nerves, or blood vessels. Read More

World J Plast Surg 2018 Jan;7(1):12-15

Department of Plastic Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Extended Soft tissue defect of leg including middle and distal parts always has been a challenge for many plastic surgeons and also a frustrated problem for patients and families. To introduce the use of the soleus muscle and reverse sural flaps as synchronous surgical treatment alternative of the leg bone exposure with large soft tissue defect, this study was conducted.

Methods: The medical records of patients undergoing transposition of the soleus muscle for treating exposed bone in the leg and simultaneous sural flap were retrospectively analyzed from January 2009 to July 2014, while gathering information on the used muscle was to cover the lesion. Read More

Int J Oral Maxillofac Surg 2018 Aug 23;47(8):983-989. Epub 2018 Mar 23.

Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Tochigi, Japan.

The purpose of this study was to evaluate surgical outcomes in elderly patients who had undergone free fibula flap transfer for malignant head and neck tumours. A retrospective chart review was performed to identify patients who had undergone free fibula flap transfer for mandibular reconstruction after malignant tumour resection at Jichi Medical University Hospital between May 2009 and April 2015. Enrolled patients were divided into an elderly group (≥80years old) and a younger group (<80years old). Read More

Aust Dent J 2018 Mar;63 Suppl 1:S108-S113

Royal Brisbane and Women's Hospital, University of Queensland, Herston Qld, Australia.

Prosthetic replacements in the 19th and early 20th century were superseded by pedicled flaps and obturators. These have subsequently been superseded by free tissue transfer which currently is the mainstay of reconstructive jaw surgery. Although malignant and benign processes of the jaws are the predominant cause of segmental defects, a significant proportion still occurs due to trauma, or even iatrogenic causes such as radiotherapy. Read More

Arch Orthop Trauma Surg 2018 May 7;138(5):653-660. Epub 2018 Feb 7.

Orthopedic Department, Benha University, El-Shaheed Farid Nada Street, Kafer el Gazar, Banha, Qalyubia, 13511, Egypt.

Introduction: Several reconstructive procedures have been used in management of large tibial bone defects including bone graft, bone transport (distraction osteogenesis) using various external fixators, and vascularized bone graft. Each of these procedures has its limitations and complications. The study describes gradual medial fibular transfer using Ilizarov external fixators in management of patients with large tibial defect, either following infection or trauma. Read More

Curr Opin Otolaryngol Head Neck Surg 2018 Apr;26(2):127-133

Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Birmingham, West Midlands, UK.

Purpose Of Review: To review recent literature on the subject of free tissue transfer options in paediatric head and neck surgery, with a particular emphasis on highlighting the advantages and disadvantages of different reconstructions in the paediatric patient.

Recent Findings: Free tissue transfer in paediatric patients is predictable and applicable for a wide range of congenital and acquired defects in the head and neck. The free fibula flap is a mainstay of mandibular reconstruction and allows excellent implant-supported prosthodontic rehabilitation and growth potential at the recipient site with little or no donor site morbidity. Read More

BMC Res Notes 2017 Dec 28;10(1):769. Epub 2017 Dec 28.

Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Sriphum, Muang District, Chiang Mai, 50200, Thailand.

Background: Restoration of the lateral ankle after distal fibulectomy is a difficult reconstructive procedure. Many surgical techniques have been proposed. This report shows another fibular reconstructive option with promising outcome. Read More

Clin Anat 2018 Mar 23;31(2):169-174. Epub 2018 Jan 23.

Department of Pediatric Urology, UPMC Hamot, Erie, Pennsylvania.

The Free Fibula Osteoseptocutaneous flap is a reliable option when used in neophalloplastic procedures. It possesses intrinsic rigidity that is sufficient for penetrative intercourse, and satisfactory sensation. We review the pros and cons of this procedure, as well the anatomy and surgical steps involved. Read More

Plast Reconstr Surg 2017 Nov;140(5):1033-1041

New York, N.Y. From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center; and the Division of Plastic Surgery, Department of Surgery, Mount Sinai Health System.

Background: Open tibia fractures are commonly stratified by the Gustilo classification, an orthopedic grading system that does not incorporate the presence of arterial injury when limb perfusion is intact. In the authors' experience, however, the presence of arterial injury appears to negatively impact microsurgical outcomes.

Methods: In a retrospective review of 806 lower extremity reconstructions between 1979 and 2016, 361 soft-tissue flaps performed for Gustilo type IIIB/C coverage met inclusion criteria. Read More

J Oral Maxillofac Surg 2018 Jan 8;76(1):230.e1-230.e8. Epub 2017 Sep 8.

Fellow, Head and Neck Oncologic and Microvascular Reconstructive Surgery, Division of Oral and Maxillofacial Surgery, University of Miami-Miller School of Medicine/Jackson Health System, Miami, FL.

Osteoradionecrosis (ORN) is a well-known and usually late complication of radiation therapy in the treatment of head and neck cancer. Although the therapy can be life extending, it also produces tissue toxicity in ipsilateral and contralateral tissues in an acute and chronic fashion. In the most severe cases of ORN, such as the one presented in this report, bilateral disease results in the need for total mandibulectomy and creates a tremendous reconstructive challenge. Read More

J Craniofac Surg 2017 Nov;28(8):1955-1959

*Department of Plastic Surgery, Microsurgery and Burn Center "J. Ioannovich," General State Hospital of Athens "G. Gennimatas;" †Department of Oral and Maxillofacial Surgery, General State Hospital of Athens "G. Gennimatas," Athens, Greece.

Background: Free fibula flap is an option for primary restoration after disarticulation mandibular resection, though literature on technique refinements is scarce. The authors hypothesized that inset of the masseter, the key mandibular elevator muscle, at the reconstructed mandible may optimize functional recovery.

Methods: All patients undergoing reconstruction of mandibulectomy-condylectomy defect (January 2009 to January 2014) by means of a fibular flap were prospectively studied. Read More

Ann Surg Oncol 2017 Dec 7;24(13):4009-4016. Epub 2017 Sep 7.

Department of Plastic Surgery, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA.

Background: Free tissue transfer in the pediatric population is a challenging endeavor, even for experienced microsurgeons. Some surgeons argue these cases can be limited by vessel size and spasticity and should be undertaken only when absolutely necessary. We present a 15-year experience examining outcomes of free tissue transfer in pediatric oncologic patients. Read More

Foot Ankle Int 2017 Nov 24;38(11):1207-1214. Epub 2017 Aug 24.

1 Department of Orthopaedic Surgery, Inje University, Haeundae Paik Hospital, Busan, South Korea.

Background: The modified Broström procedure (MBP) is widely accepted as the primary operative treatment for chronic lateral ankle instability (CLAI). However, the MBP does not produce good clinical results in all patients, and anatomic reconstruction using a free tendon graft may be considered in those patients. The purpose of this study was to evaluate the efficacy of the MBP using distal fibular periosteal flap augmentation for CLAI in patients who were not candidates for standard repair. Read More

Microsurgery 2017 Nov 28;37(8):902-909. Epub 2017 Jul 28.

Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.

Background: Reconstruction in a vessel-depleted neck is challenging. The success rates can be markedly decreased because of unavailability of suitable recipient vessels. In order to obtain a reliable flow, recipient vessels away from the zone of fibrosis, radiation, or infection need to be explored. Read More

HSS J 2017 Jul 19;13(2):178-185. Epub 2016 Sep 19.

Orthopedic Department, Al-Demerdash Hospital, Ain Shams University, Abbassia Square, Abbassia, 11381 Cairo, Egypt.

Background: Fibular hemimelia is a congenital disorder that is characterized by the absence of the fibula that could be either partial or complete. Successful management aims to restore normal weight bearing and normal limb length. The introduction of the Ilizarov method of limb lengthening has provided an attractive alternative to amputation. Read More

Stomatologiia (Mosk) 2017;96(2):25-28

Russian Medical Academy of Post-Graduate Education, Moscow, Russia.

The paper presents the impact of perioperative care on feasibility of free fibula flap transfer for facial reconstruction. Flaps vitality was measured by means of somatic oximetry in 85 patients aged 20-74 years receiving reconstruction procedures in midfacial and lower facial areas. The patients were divided in three groups according to sedation agent used postoperatively. Read More

J Craniofac Surg 2017 May;28(3):659-663

Department of Plastic, Reconstructive and Aesthetic Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Reconstruction of a midfacial defect can represent a difficult challenge for the plastic surgeon. Although many midfacial deformities have traumatic or congenital origins, the vast majority of head and neck defects occur after resection of malignant head and neck neoplasms. Autogenous reconstruction is now routinely performed for larger, complex defects resulting from surgical resection or trauma. Read More

Int J Oral Maxillofac Surg 2017 Aug 19;46(8):946-957. Epub 2017 Apr 19.

Department of Maxillofacial, Plastic, Reconstructive and aesthetic Surgery, Henri Mondor Hospital, Créteil, France.

Very few surgical teams currently use totally independent and free solutions to perform three-dimensional (3D) surgical modelling for osseous free flaps in reconstructive surgery. This study assessed the precision and technical reproducibility of a 3D surgical modelling protocol using free open-source software in mandibular reconstruction with fibula free flaps and surgical guides. Precision was assessed through comparisons of the 3D surgical guide to the sterilized 3D-printed guide, determining accuracy to the millimetre level. Read More

Int J Surg Pathol 2017 Aug 7;25(5):462-467. Epub 2017 Apr 7.

3 Department of Orthopedics Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Malignant peripheral nerve sheath tumor (MPNST) is a rare form of sarcoma arising from Schwann cells or pluripotent cells of the neural crest. Malignant triton tumor (MTT) is a subtype of MPNST with a component of malignant rhabdomyoblasts in addition to malignant Schwann cells. MPNST and MTT are both aggressive malignancies that most commonly arise from large deep neurofibromas in patients with neurofibromatosis type 1 (NF-1). Read More

Otolaryngol Head Neck Surg 2017 04 21;156(4):627-635. Epub 2017 Mar 21.

3 Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon.

Objective To compare outcomes after microvascular reconstructions of head and neck defects between overlapping and nonoverlapping operations. Study Design Retrospective cohort study. Setting Tertiary care center. Read More

Plast Reconstr Surg Glob Open 2017 Feb 22;5(2):e1218. Epub 2017 Feb 22.

Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center School of Medicine, New Orleans, La.; Department of Plastic and Reconstructive Surgery, Johns Hopkins Medical Institute, Baltimore, Md.; Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, N.Y.; and Division of Plastic Surgery, University of Montreal, Montreal, QC.

Background: We have adopted an intraoral microsurgical anastomosis to the facial vessels to eliminate the need for any visible facial incisions.

Methods: Cadaveric dissection was used to demonstrate accessibility of the facial artery and vein through an intraoral approach. Additionally, 5 patients underwent free tissue transfer for reconstruction of major defects of the midface through an intraoral, transmucosal approach, obviating the need for visible skin incisions. Read More

J Reconstr Microsurg 2017 Jul 4;33(6):441-445. Epub 2017 Mar 4.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

 Three-dimensional (3D) printing has developed as a revolutionary technology with the capacity to design accurate physical models in preoperative planning. We present our experience in surgeon-based design of 3D models, using home 3D software and printing technology for use as an adjunct in vascularized bone transfer.  Home 3D printing techniques were used in the design and execution of vascularized bone flap transfers to the upper extremity. Read More

Int J Oral Maxillofac Surg 2017 Jul 21;46(7):871-876. Epub 2017 Feb 21.

Oral-Head and Neck Surgery/Microvascular Surgery, University of Maryland Greenebaum Cancer Center, Baltimore, Maryland, USA. Electronic address:

A retrospective review of all patients with stage 3 medication-related osteonecrosis of the jaw (MRONJ), treated by surgical resection and immediate vascularized bone reconstruction at a tertiary care medical center, was performed. Eleven patients were included, seven female and four male; their mean age was 65.8 years (range 56-73 years). Read More

Beijing Da Xue Xue Bao Yi Xue Ban 2017 02;49(1):1-5

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.

The maxilla is the most important bony support of the mid-face skeleton and is critical for both esthetics and function. Maxillary defects, resulting from tumor resection, can cause severe functional and cosmetic deformities. Furthermore, maxillary reconstruction presents a great challenge for oral and maxillofacial surgeons. Read More

J Plast Surg Hand Surg 2017 Oct 2;51(5):358-361. Epub 2017 Feb 2.

a Department of Plastic and Reconstructive Surgery , Keio University , Tokyo , Japan.

Background: In mandibular reconstruction with vascularised free fibula transfer, there are situations where the neck on the operated site lacks recipient vessels for vascular anastomosis due to previous radiological/surgical interventions.

Methods: The present study aims to clarify the availability of neck vessels on the contralateral side in such situations. Experimental surgery was conducted on 20 fresh cadavers (six males and 14 females). Read More

J Oral Maxillofac Surg 2017 Jun 11;75(6):1302.e1-1302.e7. Epub 2016 Dec 11.

Assistant Professor of Surgery, Division of Oral and Maxillofacial Surgery, Miller School of Medicine, University of Miami, Miami, FL; Associate Program Director, Division of Oral and Maxillofacial Surgery, Naval Medical Center Portsmouth, Portsmouth, VA; and Assistant Professor of Surgery, Department of Surgery, Uniformed Services University of Health Sciences, Bethesda, MD. Electronic address:

Microsurgical reconstructive techniques have revolutionized the treatment of large head and neck defects. These defects were once forever life altering because of the considerable morbidity to both the form and function of the patient. As time has progressed, microsurgical technique has improved dramatically and has become institutionalized in our training programs. Read More

J Craniofac Surg 2016 Nov;27(8):2134-2137

*Hansjörg Wyss Department of Plastic Surgery†Department of Radiology, New York University School of Medicine, Langone Medical Center, New York, NY.

An accurate and comprehensive understanding of lower extremity arterial anatomy is essential for the successful harvest and transfer of a free fibula osteoseptocutaneous flap (FFF). Minimum preoperative evaluation includes detailed history and physical including lower extremity pulse examination. Controversy exists regarding whether preoperative angiographic imaging should be performed for all patients. Read More

J Plast Reconstr Aesthet Surg 2017 Jan 27;70(1):1-11. Epub 2016 Jul 27.

Department of Plastic & Reconstructive Surgery, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, Queensland, Australia; Southside Clinical Division, School of Medicine, University of Queensland, 199 Ipswich Rd, Woolloongabba, Queensland, Australia.

Background: Since the description of the free fibula flap by Taylor in 1975, many flaps composed of bone have been described. This review documents the history of vascularised bone transfer and reflects on the current understanding of blood supply in an effort to define all clinically described osseous flaps.

Methods: A structured review of MEDLINE and Google Scholar was performed to identify all clinically described bone flaps in humans. Read More

Laryngoscope 2017 04 12;127(4):815-819. Epub 2016 Oct 12.

Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, U.S.A.

Objective: Acute invasive fungal sinusitis (AIFS) is a frequently fatal infection for which extensive and debilitating surgical debridement is a mainstay of therapy. Resulting defects are often composite in nature, mandating free tissue-transfer reconstruction. Outcomes data for free flap reconstruction are limited. Read More

J Reconstr Microsurg 2017 Feb 21;33(2):118-123. Epub 2016 Oct 21.

Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.

 Although proximal fibular flaps have been widely applied in wrist arthroplasty, controversy remains regarding which side of the proximal fibula is better for reconstruction of the distal radius. If the articular surface of the proximal fibula shows dorsal tilting, the ipsilateral (right) proximal fibula should be harvested in right wrist arthroplasty because the articular surface of the distal radius normally has volar tilt. This study investigated anatomical similarities between the proximal fibular articular surface and the distal radius articular surface based on morphologic analysis of the proximal fibula using computed tomography (CT). Read More

Plast Reconstr Surg Glob Open 2016 May 25;4(5):e718. Epub 2016 May 25.

Division of Plastic and Reconstructive Surgery and Otolaryngology-Head & Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.

Free tissue transfer has become the mainstay of head and neck cancer (HNC) reconstructive surgery. The objective of the study is to examine the efficacy of the Harmonic Scalpel (HS) Shears on free flap elevation time and complication rates after HNC reconstruction compared with traditional electrocautery. A retrospective review of 215 HNC patients undergoing surgical ablation and free flap reconstruction from January 2010 to April 2013 at the University of Alberta Hospital was undertaken. Read More

Head Neck 2016 08 9;38(8):1278-85. Epub 2016 May 9.

Department of Plastic, Reconstructive, Aesthetic Surgery, Maxillofacial Surgery, and Burn Unit, Hospital São João, Porto, Portugal.

Background: Current treatment guidelines caution against osseous reconstruction using free flap tissue to treat bisphosphonate-related osteonecrosis of the jaw (BRONJ). The primary rationale for this stance is the theoretical risk of nonunion and recurrence of disease within the reconstruction. Emerging evidence suggests that these theoretical risks may be overestimated. Read More

J Craniofac Surg 2016 Jun;27(4):846-56

*Department of Oral and Maxillofacial Surgery, Division of Head Neck Surgery, Division of Surgical Oncology, University of Florida College of Medicine, Jacksonville †Department of Pediatric Craniomaxillofacial Surgery, Arnold Palmer Hospital for Children, University of Central Florida, Orlando, FL ‡Head and Neck Institute §Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, Portland, OR ||Department of Oral and Maxillofacial Surgery, Section of Pediatric Oral and Maxillofacial Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI.

Background: Limited outcome data exist regarding the survival of microvascular free flaps for head and neck reconstruction in children. The objectives of this study were to perform a systematic review of the literature and meta-analysis comparing the survival of the most commonly used free flaps used for head and neck reconstruction in children.

Methods: A systematic search of PubMed, Embase, and Scopus was conducted using various keywords up to January 1, 2015. Read More

Microsurgery 2017 Jul 26;37(5):410-415. Epub 2016 Apr 26.

Pediatric Orthopedics Department, Hospital Sant Joan De Deu. Universitat De Barcelona, Barcelona, Spain.

Purpose: The purpose of this report is to evaluate the results of extending vascularized fibular grafts (VFG) with vascularized periosteum (VPG) in bone defect reconstruction in children.

Methods: Retrospective study of 10 children, mean age at surgery was 9.8 years (range, 4-16 years). Read More

J Reconstr Microsurg 2016 Sep 6;32(7):513-9. Epub 2016 Apr 6.

Department of Plastic Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Background Free vascularized fibular graft is useful in upper extremity long-bone reconstruction. The authors studied the reliability and long-term outcomes of this technique. Methods The authors included 20 patients with a minimum follow-up of 24 months in this study, and retrospectively reviewed patients' hospital records and used a preinformation form, the Disabilities of the Arm, Shoulder and Hand (DASH), the Lower Extremity Functional Scale (LEFS), and the 15D health-related quality of life (HRQoL) instrument to perform a cross-sectional assessment. Read More

Plast Reconstr Surg 2016 Apr;137(4):1292-305

Melbourne, Victoria, Australia From the Jack Brockhoff Reconstructive Plastic Surgery Research Unit-Taylor Laboratory, Department of Anatomy and Neuroscience, University of Melbourne.

Background: The first successful free vascularized bone flap was performed on June 1, 1974 (and reported in 1975), using the fibula. This was followed by the iliac crest based on the superficial circumflex iliac artery in 1975 and then the deep circumflex iliac artery in 1978.

Methods: A total of 384 transfers using fibula (n = 198), iliac crest (n = 180), radius (n = 4), rib (n = 1), and metatarsal (n = 1) were used between June of 1974 and June of 2014 for reconstruction of the mandible (n = 267), maxilla (n = 20), clavicle (n = 1), humerus (n = 8), radius and ulna (n = 21), carpus (n = 3), pelvis (n = 2), femur (n = 11), tibia (n = 47), and foot bones (n = 4). Read More

J Oral Maxillofac Surg 2016 Jun 1;74(6):1284.e1-1284.e15. Epub 2016 Feb 1.

Chairman and Associate Professor, Department of Oral and Maxillofacial Surgery and Pathology, University of Mississippi Medical Center, Jackson, MS.

Microvascular free tissue transfer has been one of the greatest milestones in reconstruction of the mandible and maxilla after tumor ablative surgery. Although fibula free flap reconstruction allows for immediate bony reconstruction, dental rehabilitation usually requires 6 to 12 months before it is completed. This can have a serious psychological impact on patients because they go without teeth during this timeframe. Read More

J Plast Reconstr Aesthet Surg 2016 Apr 17;69(4):545-53. Epub 2015 Dec 17.

Department of Vascular Surgery, University Hospital Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany.

Purpose: Free flap transplantation to vascular reconstructions as arteriovenous (AV) loops has been established in centers as a feasible therapeutic option for defect reconstruction in the absence of proper recipient vessels, caused by oncologic resections, radiation, or trauma. We report our 10-year experience in free flap transplantation after vascular reconstruction with special emphasis on complication rate and postoperative mobility.

Patients And Methods: Forty-seven patients (mean age: 60 years, range: 19-86) were included. Read More

Eur Radiol 2016 Oct 20;26(10):3345-52. Epub 2016 Jan 20.

Department of Radiology, University of Michigan, Ann Arbor, MI, USA.

Unlabelled: Head and neck reconstructive surgery after cancer ablative surgery is now commonly performed with closure of the surgical defects by microvascular free tissue transfer. The most common flaps used for reconstruction are the radial forearm flap, the anterolateral thigh flap and fibula flap. Radiographic appearance of these flaps depends on the individual components of the flap, and may consist of skin, fat, muscle and/or bone. Read More