The new innovation of the lower medial thigh perforator flap for head and neck reconstruction.
BACKGROUND
The choice of optimal flap is still a challenge for patients with resection of head and neck cancer and reconstruction, especially for recurrent cases. In this article, we report the results of the new innovation of free lower medial thigh perforator (LMTP) flap for head and neck reconstruction in a series of patients.


METHODS
Fifteen patients received reconstruction with free LMTP flaps. The defect locations included the buccal area (3 cases), tongue (6 cases), lower/upper gum (5 cases), and soft palate (1 case). The perforators of flap design were detected at the distal third of the line, which was drawn from the midpoint of inguinal ligament to medial upper border of patella. The superficial temporal artery (7 cases), superior thyroid artery (6 cases), and facial artery (2 cases) were dissected as recipient vessels.


RESULTS
The flap sizes varied from 12 × 5 cm(2) to 20 × 8 cm(2) . One to two perforators based on the superficial femoral artery or descending genicular artery were found between the septum of satorius and vastus medialis, or piercing the vastus medialis during dissection. All of flaps were survived after surgery, except one failed due to venous thrombosis. Another one flap suffered from venous thrombosis and was successfully salvaged by performing a venous thrombectomy. All donor sites were primarily closed except one skin grafting. The follow-up time ranged from 3 to 15 months (average: 7 months) and all patients had good recovery with satisfactory results.


CONCLUSIONS
The LMTP flap indicates a pliable with constant vascular anatomy and low donor-site morbidity. It could be an alternative for reconstructing defects in head and neck region. © 2015 Wiley Periodicals, Inc. Microsurgery 36:284-290, 2016.
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.|Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Mario F
MF
Scaglioni
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.|Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Pao-Jen
PJ
Kuo
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.|Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Yen-Chou
YC
Chen
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.|Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Pao-Yuan
PY
Lin
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.|Chang Gung University College of Medicine, Kaohsiung, Taiwan.|Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.|Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Yur-Ren
YR
Kuo
D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000098:blood supply / Q000637:transplantation*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013848:Thigh; D016896:Treatment Outcome