Brown, JS, Lowe, D, Kanatas, A et al. (1 more author) (2017) Mandibular reconstruction with vascularised bone flaps: a systematic review over 25 years. British Journal of Oral and Maxillofacial Surgery, 55 (2). pp. 113-126. ISSN 0266-4356
Abstract
To explore the techniques for mandibular reconstruction with composite free flaps and their outcomes, we systematically reviewed reports published between 1990 and 2015. A total of 9499 mandibular defects were reconstructed with 6178 fibular, 1380 iliac crest, 1127 composite radial, 709 scapular, 63 serratus anterior and rib, 32 metatarsal, and 10 lateral arm flaps including humerus. The failure rate was higher for the iliac crest (6.2%, 66/1059) than for fibular, radial, and scapular flaps combined (3.4%, 202/6018) (p<0.001). We evaluated rates of osteotomy, non-union, and fistulas. Implant-retained prostheses were used most often for rehabilitation after reconstruction with iliac crest (44%, 100/229 compared with 26%, 605/2295 if another flap was used) (p<0.001). There were no apparent changes in the choice of flap or in the complications reported. Although we were able to show some significant differences relating to the types of flap used, we were disappointed to find that fundamental outcomes such as the need for osteotomy, and rates of non-union and fistulas were under-reported. This review shows the need for more comprehensive and consistent reporting of outcomes to enable the comparison of different techniques for similar defects.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | Crown Copyright © 2017 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons. All rights reserved. This is an author produced version of a paper published in the British Journal of Oral and Maxillofacial Surgery. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Mandible; reconstruction; free tissue transfer; head and neck; reconstructive microsurgery |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Dentistry (Leeds) > School of Dentistry Visitors (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 10 Feb 2017 12:21 |
Last Modified: | 05 Jan 2018 01:38 |
Published Version: | https://doi.org/10.1016/j.bjoms.2016.12.010 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.bjoms.2016.12.010 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:112194 |