title: Chimeric groin free flaps: Design and clinical application.
abstract: BACKGROUND
  Reconstruction of composite extremity defects or through-and-through oral defects remains challenging for surgeons. Chimeric flaps are ideal for repairing these lesions. In this article, we report the design of various chimeric groin free flaps for the reconstruction of both complex oral and extremity defects in 18 patients.
  
  
  METHODS
  Between 2010 and 2014, 18 patients with composite tissue defect or two defects in the extremities or head and neck region, underwent reconstruction with cutaneous-cutaneous, musculo-cutaneous, or osteo-cutaneous chimeric groin free flaps. The size and pedicles length of the chimeric groin flaps based on the superficial circumflex iliac artery (SCIA) were tailored to the lesions. Patient-reported post-operative outcomes at the out-patient department were evaluated.
  
  
  RESULTS
  The types of chimeric groin free flaps included cutaneous-cutaneous (n = 12), musculo-cutaneous (n = 1), and osteo-cutaneous (n = 5) flaps. Three to four SCIA branches (mean: 3.33) could be used for flap design. The cutaneous flap size ranged from 1.5 cm × 6 cm to 11 cm × 30 cm, and the bone flap size ranged from 1 cm × 1.5 cm to 2.5 cm × 6 cm. All flaps survived, and no significant complications developed at recipient or donor sites. Functional recovery after reconstruction was satisfactory in most patients after a mean of 17.27 months (ranging 2-42 months) of follow-up.
  
  
  CONCLUSIONS
  The innovative flap technique presented herein has advantages including greater reliability, as well as the ability to tailor the dimensions and flap paddles to specific lesions and reconstruct two defects or one composite defect using only one (chimeric) flap.
authors.affiliation: Institute of Medicine & School of Medicine, Chung Shan Medical University, Taichung, Taiwan.|Division of Plastic Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.|Chienkuo Technology University, Changhua, Taiwan.
authors.forename: Wai-Nang
authors.initials: WN
authors.lastname: Chao
authors.affiliation: Institute of Medicine & School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Po-Hui
authors.initials: PH
authors.lastname: Wang
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Liouying Chi-Mei Hospital, Tainan, Taiwan.
authors.forename: Bing-Ren
authors.initials: BR
authors.lastname: Chen
authors.affiliation: Institute of Medicine & School of Medicine, Chung Shan Medical University, Taichung, Taiwan.|Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Shiuan-Chih
authors.initials: SC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005121:Extremities / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation*; D006119:Groin / Q000601:surgery*; D006257:Head / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies