title: Osteomyocutaneous peroneal artery-based combined flap for reconstruction of composite and en bloc mandibular defects.
abstract: BACKGROUND
  The osteomyocutaneous peroneal artery-based combined (OPAC) flap is a refinement of fibula osteoseptocutaneous flap, with the inclusion of partial soleus muscle based on an independent myocutaneous perforator.
  
  
  METHODS
  Seventeen men underwent composite oromandibular reconstruction using an OPAC flap. Flaps were raised with 1 or 2 skin paddles and 2 to 3 bone segments. In 8 cases, a portion of soleus muscle was included.
  
  
  RESULTS
  All flaps survived, but partial failure occurred in 2 cases (11.7%). At a mean follow-up of 25.3 +/- 19.4 months, 6 of 12 patients tolerated a regular diet, 5 a soft diet, and 1 a liquid diet. Speech was normal in 2 patients, intelligible in 4, and slurred in 6.
  
  
  CONCLUSIONS
  Advantages of the OPAC flap include a single donor site, 1 pair of recipient vessels, versatile 3-dimensional inset, adequate soft tissue augmentation, and better aesthetic and functional outcomes.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan. minghueicheng@gmail.com
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Cheng
authors.forename: Michel
authors.initials: M
authors.lastname: Saint-Cyr
authors.forename: Rozina S
authors.initials: RS
authors.lastname: Ali
authors.forename: Kai-Ping
authors.initials: KP
authors.lastname: Chang
authors.forename: Sheng-Po
authors.initials: SP
authors.lastname: Hao
authors.forename: Fu-Chan
authors.initials: FC
authors.lastname: Wei
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005360:Fibula / Q000637:transplantation; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D018482:Muscle, Skeletal / Q000637:transplantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D013060:Speech; D013524:Surgical Flaps / Q000098:blood supply*; D016909:Tibial Arteries / Q000637:transplantation