Surgical oncology and reconstructionDevelopments in Image-Guided Deep Circumflex Iliac Artery Flap Harvest: A Step-by-Step Guide and Literature Review
Section snippets
Patients and Methods
Our clinical approach as described was based on implementation of these techniques in a cohort of 20 consecutive patients (12 men and 8 women) who underwent DCIA flap reconstruction for an oncologic defect. The patients had an age range of 39 to 75 years and a range of body habitus (Table 1). All patients provided written informed consent for inclusion, and their cases were deemed clinically appropriate for DCIA flap surgery, with no exclusions. The technique described was based on a
Results
CTA and stereolithographic models were performed and made for 20 consecutive patients undergoing DCIA reconstruction (Table 1). All patients had clear oncologic clearance. Intraoperative adjustments of the resections were all within 1 cm of the preoperatively planned models. All patients underwent successful dissection and elevation of their DCIA flap, and no complete flap failures occurred. The concordance between the imaging and operative findings of the pedicle was 95%, with 100% concordance
Discussion
The iliac crest has long been recognized to be an excellent source of bone graft material and was widely used as a nonvascularized graft as early as World War I, with poor results.22, 23 It was not until the 1970s, with the developments in microsurgery and vascularized transfers, that surgeons were able to markedly improve the iliac bone graft survival rate. The vascularized DCIA flap was popularized in association with an inconspicuous donor scar and low donor site morbidity.24, 25, 26 In
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Intraoral anastomosis of a vascularized iliac-crest flap in maxillofacial reconstruction
2019, Journal of Plastic, Reconstructive and Aesthetic SurgeryCitation Excerpt :Although rare, donor site morbidity can cause gait disturbances,31 which did not occur in this study because ASISs and attachments of the inguinal ligament and sartorius were preserved. Furthermore, DCIA flaps offer an additional advantage of a discreetly hidden donor- site scar.32,33 With DCIA flaps, the intraoral anastomosing technique presents another main advantage: the pedicle of DCIA is approximately 5 cm and thus too short to reach the submandibular or preauricular vessels, particularly for maxillary reconstruction.
Vascularized Iliac Crest Grafts
2017, Maxillofacial Surgery, 3rd Edition: Volume 1-2The Versatility of the DCIA Free Flap: A Forgotten Flap? Systematic Review and Meta-Analysis
2022, Journal of Reconstructive MicrosurgeryAbdominal-based free flaps in head and neck reconstruction
2021, Current Opinion in Otolaryngology and Head and Neck SurgeryThree-dimensional Printing Technology for Deep Circumflex Iliac Artery Flap: From Recipient to Donor Sites
2021, Plastic and Reconstructive Surgery - Global Open