Evaluation of facial artery perforator-based flaps in reconstruction of facial defects

Introduction: Several flaps have been described for reconstructing facial or oral defects. Flaps such as forehead and pectoralis major are often too bulky for small-to-moderate-sized defects, for which nasolabial flaps are often ideal. However, nasolabial flaps have limited mobility and reach and ma...

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Main Authors: Goutam Guha, Dipmalya Chatterjee, Siddhartha Biswas, Kaushik Das, Rupnarayan Bhattacharya, Tapan Sarkar
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2017-09-01
Series:Indian Journal of Plastic Surgery
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_91_16
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author Goutam Guha
Dipmalya Chatterjee
Siddhartha Biswas
Kaushik Das
Rupnarayan Bhattacharya
Tapan Sarkar
author_facet Goutam Guha
Dipmalya Chatterjee
Siddhartha Biswas
Kaushik Das
Rupnarayan Bhattacharya
Tapan Sarkar
author_sort Goutam Guha
collection DOAJ
description Introduction: Several flaps have been described for reconstructing facial or oral defects. Flaps such as forehead and pectoralis major are often too bulky for small-to-moderate-sized defects, for which nasolabial flaps are often ideal. However, nasolabial flaps have limited mobility and reach and may need two stages, particularly for intraoral defects. According to recent literatures, facial artery provides numerous small cutaneous perforators, based on which skin flaps can be islanded, with greater mobility and reach for reconstruction of small-to-moderate-sized intraoral and facial defects in one stage. Our study aims to evaluate the reliability and versatility of facial artery perforator-based flaps in the reconstruction of such defects. Materials and Methods: A ethical committee-approved retrospective study was conducted on data of the patients attending our outpatient department between February 2014 and October 2015 with small-to-moderate-sized facial/oral lesions. The total sample size was 23. We studied the relation of flap survival with size of flap, route of inset and neck dissection, functional and aesthetic outcomes and feasibility of adjuvant therapy in cases of malignancies. Results and Analysis: A wide range of facial defects, especially intraoral defects, could be reconstructed in one stage using facial artery perforator-based flaps. The flaps were reliable. Complications included only partial skin loss of the flaps in a few cases. Complications were directly related to the length of the flaps and the route of inset. Functional and aesthetic outcomes were satisfactory and none of the flaps showed any significant post-radiotherapy changes. Conclusions: We concluded that facial artery perforator flap can be a simple, safe, versatile and one-stage alternative to the traditional flaps in the reconstruction of small-to-moderate-sized facial defects. Neck dissection can be safely done in the same sitting.
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spelling doaj-art-d99a4615ee7f4711b6854d5b034afbda2025-08-20T02:03:47ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2017-09-01500326627210.4103/ijps.IJPS_91_16Evaluation of facial artery perforator-based flaps in reconstruction of facial defectsGoutam Guha0Dipmalya Chatterjee1Siddhartha Biswas2Kaushik Das3Rupnarayan Bhattacharya4Tapan Sarkar5Department of Plastic and Reconstructive Surgery, R. G. Kar Medical College, Kolkata, West Bengal, IndiaDepartment of Plastic and Reconstructive Surgery, R. G. Kar Medical College, Kolkata, West Bengal, IndiaDepartment of Plastic and Reconstructive Surgery, R. G. Kar Medical College, Kolkata, West Bengal, IndiaDepartment of Plastic and Reconstructive Surgery, R. G. Kar Medical College, Kolkata, West Bengal, IndiaDepartment of Plastic and Reconstructive Surgery, R. G. Kar Medical College, Kolkata, West Bengal, IndiaDepartment of Plastic and Reconstructive Surgery, R. G. Kar Medical College, Kolkata, West Bengal, IndiaIntroduction: Several flaps have been described for reconstructing facial or oral defects. Flaps such as forehead and pectoralis major are often too bulky for small-to-moderate-sized defects, for which nasolabial flaps are often ideal. However, nasolabial flaps have limited mobility and reach and may need two stages, particularly for intraoral defects. According to recent literatures, facial artery provides numerous small cutaneous perforators, based on which skin flaps can be islanded, with greater mobility and reach for reconstruction of small-to-moderate-sized intraoral and facial defects in one stage. Our study aims to evaluate the reliability and versatility of facial artery perforator-based flaps in the reconstruction of such defects. Materials and Methods: A ethical committee-approved retrospective study was conducted on data of the patients attending our outpatient department between February 2014 and October 2015 with small-to-moderate-sized facial/oral lesions. The total sample size was 23. We studied the relation of flap survival with size of flap, route of inset and neck dissection, functional and aesthetic outcomes and feasibility of adjuvant therapy in cases of malignancies. Results and Analysis: A wide range of facial defects, especially intraoral defects, could be reconstructed in one stage using facial artery perforator-based flaps. The flaps were reliable. Complications included only partial skin loss of the flaps in a few cases. Complications were directly related to the length of the flaps and the route of inset. Functional and aesthetic outcomes were satisfactory and none of the flaps showed any significant post-radiotherapy changes. Conclusions: We concluded that facial artery perforator flap can be a simple, safe, versatile and one-stage alternative to the traditional flaps in the reconstruction of small-to-moderate-sized facial defects. Neck dissection can be safely done in the same sitting.http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_91_16facial arterynasolabial flapperforatorpropeller flap
spellingShingle Goutam Guha
Dipmalya Chatterjee
Siddhartha Biswas
Kaushik Das
Rupnarayan Bhattacharya
Tapan Sarkar
Evaluation of facial artery perforator-based flaps in reconstruction of facial defects
Indian Journal of Plastic Surgery
facial artery
nasolabial flap
perforator
propeller flap
title Evaluation of facial artery perforator-based flaps in reconstruction of facial defects
title_full Evaluation of facial artery perforator-based flaps in reconstruction of facial defects
title_fullStr Evaluation of facial artery perforator-based flaps in reconstruction of facial defects
title_full_unstemmed Evaluation of facial artery perforator-based flaps in reconstruction of facial defects
title_short Evaluation of facial artery perforator-based flaps in reconstruction of facial defects
title_sort evaluation of facial artery perforator based flaps in reconstruction of facial defects
topic facial artery
nasolabial flap
perforator
propeller flap
url http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_91_16
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AT kaushikdas evaluationoffacialarteryperforatorbasedflapsinreconstructionoffacialdefects
AT rupnarayanbhattacharya evaluationoffacialarteryperforatorbasedflapsinreconstructionoffacialdefects
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