Oral-Head & Neck Surgery/Microvascular Reconstructive Surgery, Department of Oral & Maxillofacial Surgery, University of Maryland, 650 West Baltimore St. Rm, Baltimore, MD, 1215, USA.
Operative Unit of Maxillo-Facial Surgery, Head and Neck Department, University Hospital of Parma, Parma, Italy.
Oral Maxillofac Surg. 2021 Sep;25(3):395-400. doi: 10.1007/s10006-020-00930-y. Epub 2021 Jan 7.
The aim of the present study was to perform a comparative analysis of the utility, outcomes, and complications of DCIA (deep circumflex iliac artery) flap for the reconstruction of maxillofacial defects between two institutions that continue to use the DCIA flap as a reconstructive resource.
This retrospective analysis included a total of 68 patients (mean age 51.1 years) at the University Hospital of Parma, Parma, Italy, and the University of Maryland, Baltimore, USA, between January 2010 and April 2019.
No statistical differences were found in relation to the site of reconstruction (p = 0.09), bone graft quantity (p = 0.93), rehabilitation with dental implants (p = 0.464), length of hospitalization (p = 0.086), BMI (0.677), swallow function (p = 0.419), medical comorbidities (p = 0.933), pre-existing radiation (p = 0.691), adjuvant treatment (p = 0.298), ECOG-PS pre-and post-surgery (p = 0.329; p = 0.545), and flap failure: one partial failure observed (p = 0.412) and donor site morbidities (p = 0.742). A noted trend to increased risk of hernia without the use of a primary mesh repair was observed (p = 0.059).
The DCIA free flap represents a useful and reliable reconstructive flap for maxillofacial reconstruction. Reconstructive microvascular surgeons should be proficiently trained in this flap technique for its consideration as a first-line option in maxillofacial reconstruction.
本研究旨在对两家机构的深回旋髂动脉（DCIA）皮瓣在颌面缺损重建中的应用、结果和并发症进行比较分析，这两家机构仍将 DCIA 皮瓣作为重建资源。
这项回顾性分析共纳入了意大利帕尔马大学医院（University Hospital of Parma，Parma）和美国马里兰大学巴尔的摩分校（University of Maryland，Baltimore）的 68 例患者（平均年龄 51.1 岁），时间为 2010 年 1 月至 2019 年 4 月。
在重建部位（p = 0.09）、骨移植量（p = 0.93）、牙种植体康复（p = 0.464）、住院时间（p = 0.086）、BMI（0.677）、吞咽功能（p = 0.419）、合并症（p = 0.933）、预先存在的放疗（p = 0.691）、辅助治疗（p = 0.298）、ECOG-PS 术前和术后（p = 0.329；p = 0.545）以及皮瓣失败方面均未发现统计学差异：仅观察到一例部分皮瓣失败（p = 0.412）和供区并发症（p = 0.742）。观察到不使用原发性网片修复时疝的风险增加的趋势（p = 0.059）。
DCIA 游离皮瓣是颌面重建的一种有用且可靠的重建皮瓣。重建显微血管外科医生应熟练掌握这种皮瓣技术，将其作为颌面重建的一线选择。
