title: Bilobed fibula flap for reconstruction of through-and-through oromandibular defects.
abstract: BACKGROUND
  The role of fibula free flaps for reconstruction of through-and-through oromandibular defects is examined.
  
  
  METHODS
  Thirty-four patients underwent reconstruction of through-and-through oromandibular defects using fibula free flaps that contain large, bilobed skin paddles for simultaneous reconstruction of intraoral mucosa and external skin. We examined the incidence of wound healing complications, the need for revision reconstructive surgery, and factors affecting the incidence of complications.
  
  
  RESULTS
  Wound healing complications occurred in 50% of patients. There was a relatively high incidence of partial flap necrosis (26%) and revision surgery (41%). The area of the flap skin paddle was significantly associated with the risk of partial flap necrosis and the need for revision surgery.
  
  
  CONCLUSIONS
  Many through-and-through oromandibular defects can be successfully reconstructed using a fibula free flap that contains a large, bilobed skin paddle. However, wound healing complications are increased when the flap skin paddle area exceeds 300 cm2.
authors.affiliation: Department of Surgery, Division of Head and Neck Surgery, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
authors.forename: Meena
authors.initials: M
authors.lastname: Said
authors.forename: Ryan
authors.initials: R
authors.lastname: Heffelfinger
authors.forename: Joel A
authors.initials: JA
authors.lastname: Sercarz
authors.forename: Elliot
authors.initials: E
authors.lastname: Abemayor
authors.forename: Christian
authors.initials: C
authors.lastname: Head
authors.forename: Keith E
authors.initials: KE
authors.lastname: Blackwell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005153:Facial Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008339:Mandibular Neoplasms / Q000601:surgery*; D008875:Middle Aged; D009336:Necrosis; D019651:Plastic Surgery Procedures; D012086:Reoperation; D013524:Surgical Flaps / Q000473:pathology; D014945:Wound Healing