Management of Free Fillet Flap Transfers in Large Oncologic Resections
Background:. The fillet flap is a reliable flap for reconstruction of large deformities following oncologic resection. It provides healthy, nonradiated tissue for coverage with the secondary benefit of preserving other potential donor sites for reconstruction. Methods:. A retrospective review of the...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-11-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004689 |
| _version_ | 1811216638009147392 |
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| author | Nellie V. Movtchan, MD Lyndsay A. Kandi, BS Chad M. Teven, MD Edward M. Reece, MBA, MD Alanna M. Rebecca, MBA, MD |
| author_facet | Nellie V. Movtchan, MD Lyndsay A. Kandi, BS Chad M. Teven, MD Edward M. Reece, MBA, MD Alanna M. Rebecca, MBA, MD |
| author_sort | Nellie V. Movtchan, MD |
| collection | DOAJ |
| description | Background:. The fillet flap is a reliable flap for reconstruction of large deformities following oncologic resection. It provides healthy, nonradiated tissue for coverage with the secondary benefit of preserving other potential donor sites for reconstruction.
Methods:. A retrospective review of the medical records of eight patients who underwent fillet flap reconstruction from 2013 to 2021 at Mayo Clinic, Arizona, were analyzed.
Results:. Eight patients who underwent four hemipelvectomies, three forequarter amputations, and one below the knee amputation were identified. Patients’ ages ranged between 24 and 66 years. All indications for oncologic ablation were curative. Defect sizes ranged from 16 × 20 to 30 × 60 cm. Four pedicled flaps and four free fillet flaps were performed. Indication for free fillet flap was tumor invasion of local vascular structures. There was no flap loss in the pedicled group (follow-up ranged from 1 to 9 years), and one of four free fillet flaps had a successful long-term outcome (follow-up 36 months).
Conclusions:. Successful free fillet flap reconstruction in the setting of oncologic resection is a difficult task to achieve. Changes to the management of case 3F allowed for a successful transfer. Immediate elevation and anastomosis of the flap before oncologic resection, large caliber recipient vessels and isolation from the zone of injury, protection of the anastomosis, and delay in flap inset all contributed to flap survival. It is our belief that applying these general considerations in large oncologic resections with free fillet flap transfer may aid in successful flap transfer and improve its survival odds. |
| first_indexed | 2024-04-12T06:42:36Z |
| format | Article |
| id | doaj.art-78992de469594ff183e7e5765c7d46f5 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-12T06:42:36Z |
| publishDate | 2022-11-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-78992de469594ff183e7e5765c7d46f52022-12-22T03:43:40ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742022-11-011011e468910.1097/GOX.0000000000004689202211000-00064Management of Free Fillet Flap Transfers in Large Oncologic ResectionsNellie V. Movtchan, MD0Lyndsay A. Kandi, BS1Chad M. Teven, MD2Edward M. Reece, MBA, MD3Alanna M. Rebecca, MBA, MD4From the * Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Ariz.† University of Arizona: College of Medicine, Tucson, Ariz.‡ Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwestern Medicine, Chicago, Ill.† University of Arizona: College of Medicine, Tucson, Ariz.From the * Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Ariz.Background:. The fillet flap is a reliable flap for reconstruction of large deformities following oncologic resection. It provides healthy, nonradiated tissue for coverage with the secondary benefit of preserving other potential donor sites for reconstruction. Methods:. A retrospective review of the medical records of eight patients who underwent fillet flap reconstruction from 2013 to 2021 at Mayo Clinic, Arizona, were analyzed. Results:. Eight patients who underwent four hemipelvectomies, three forequarter amputations, and one below the knee amputation were identified. Patients’ ages ranged between 24 and 66 years. All indications for oncologic ablation were curative. Defect sizes ranged from 16 × 20 to 30 × 60 cm. Four pedicled flaps and four free fillet flaps were performed. Indication for free fillet flap was tumor invasion of local vascular structures. There was no flap loss in the pedicled group (follow-up ranged from 1 to 9 years), and one of four free fillet flaps had a successful long-term outcome (follow-up 36 months). Conclusions:. Successful free fillet flap reconstruction in the setting of oncologic resection is a difficult task to achieve. Changes to the management of case 3F allowed for a successful transfer. Immediate elevation and anastomosis of the flap before oncologic resection, large caliber recipient vessels and isolation from the zone of injury, protection of the anastomosis, and delay in flap inset all contributed to flap survival. It is our belief that applying these general considerations in large oncologic resections with free fillet flap transfer may aid in successful flap transfer and improve its survival odds.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004689 |
| spellingShingle | Nellie V. Movtchan, MD Lyndsay A. Kandi, BS Chad M. Teven, MD Edward M. Reece, MBA, MD Alanna M. Rebecca, MBA, MD Management of Free Fillet Flap Transfers in Large Oncologic Resections Plastic and Reconstructive Surgery, Global Open |
| title | Management of Free Fillet Flap Transfers in Large Oncologic Resections |
| title_full | Management of Free Fillet Flap Transfers in Large Oncologic Resections |
| title_fullStr | Management of Free Fillet Flap Transfers in Large Oncologic Resections |
| title_full_unstemmed | Management of Free Fillet Flap Transfers in Large Oncologic Resections |
| title_short | Management of Free Fillet Flap Transfers in Large Oncologic Resections |
| title_sort | management of free fillet flap transfers in large oncologic resections |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004689 |
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