title: Current role of the iliac crest flap in mandibular reconstruction.
abstract: The purpose of this study was to examine the current role of the iliac crest osteocutaneous flap in mandibular reconstruction, with a focus on the reliability of its skin island. We reviewed outcomes in 18 cases of immediate mandibular reconstruction with the iliac crest flap. Intraoral mucosal defects were closed with the skin island of the iliac crest flap in 13 patients (iliac crest flap group) and were closed with another free flap, because of poor circulation of the iliac crest skin island, in five patients (double-flap group). Postoperative results were poor in the iliac crest flap group. The rate of partial or total loss of the skin island was 46.2% in the iliac crest flap group and 20.0% in the double-flap group. The presence of a dominant perforator did not reduce the overall rate of recipient-site complications or reoperation. Combined use of another skin flap for intraoral lining provided better results. These results suggest that the skin island of the iliac crest flap should not be used for intraoral lining, unless adequate circulation of the skin island can be confirmed. If the circulation is questionable, combined use of another skin flap is strongly recommended.
authors.affiliation: Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan. shimiyam@ncc.go.jp
authors.forename: Shimpei
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuraba
authors.forename: Shogo
authors.initials: S
authors.lastname: Nagamatsu
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hayashi
mesh_terms: D000368:Aged; D016025:Bone Transplantation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007085:Ilium / Q000601:surgery / Q000637:transplantation*; D008297:Male; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply*; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology