The Submental Island Flap for Soft- Tissue Head and Neck Reconstruction: Step- by- Step Video Description and Long- Term Results

Université de Montréal, Montréal, Quebec, Canada
Plastic and Reconstructive Surgery (Impact Factor: 2.99). 03/2014; 133(3):684-6. DOI: 10.1097/PRS.0000000000000058
Source: PubMed


A clinical case of a man undergoing radical parotidectomy with skin resection for an intraparotid recurrence of squamous cell carcinoma is presented. A step-by-step video description of the regional submental island flap, based on the right submental vessels, is presented and discussed. Long-term results at 1 year in terms of color match at the recipient and donor sites are excellent, along with no functional consequence.
Therapeutic, V.

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Available from: Sami Moubayed, Sep 22, 2015
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    ABSTRACT: Risk factors and techniques for free flap salvage in head and neck (HN) reconstruction are poorly described. Retrospective review of all HN free flaps performed from 2000-2010. Overall, 151 (6.6%) of 2296 flaps underwent salvage for microvascular complications. Age, comorbidities, and surgeon experience (p=0.88), vein grafts and supercharging (p=0.45) did not affect flap salvage. Muscle-only flaps (p=0.002) were associated with significantly worse outcomes. Coupled venous anastomoses were superior to hand-sewn anastomoses (p=0.03). Arteriovenous thromboses had worse outcomes than a venous or arterial thrombosis alone (p<0.0001). Anticoagulation, thrombolytics, and thrombectomy did not improve survival. Multiple takebacks (p=0.003) and late takebacks (>3 days) had significantly worse outcomes (p=0.003). Flap salvage was 60.3% successful with 60 total flap losses (2.6%). While flap salvage should be attempted, multiple attempts are not recommended especially for muscle-only flaps. Combined arteriovenous and late thromboses have a dismal prognosis regardless of different salvage techniques. This article is protected by copyright. All rights reserved. © 2015 Wiley Periodicals, Inc.
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