Retrospective analysis of complications in 190 mandibular resections and simultaneous reconstructions with free fibula flap, iliac crest flap or reconstruction plate: a comparative single centre study

Objectives The purpose of this study was to evaluate the incidence of complications following mandibular reconstruction and to analyse possible contributing factors. Materials and methods Clinical data and computed tomography scans of all patients who needed a mandibular reconstruction with a reconstruction plate, free fibula flap (FFF) or iliac crest (DCIA) flap between August 2010 and August 2015 were retrospectively analysed. Results One hundred and ninety patients were enrolled, encompassing 77 reconstructions with reconstruction plate, 89 reconstructions with FFF and 24 reconstructions with DCIA flaps. Cutaneous perforation was most frequently detected in the plate subgroup within the early interval and overall (eachp= 0.004). Low body mass index (BMI) and total radiation dosage were the most relevant risk factors for the development of analysed complications. Conclusions Microvascular bone flaps have overall less skin perforation than reconstruction plates. BMI and expected total radiation dosage have to be respected in choice of reconstructive technique. Clinical relevance A treatment algorithm for mandibular reconstructions on the basis of our results is presented.

Automated summary

This study aimed to evaluate the incidence of complications following mandibular reconstruction and analyze contributing factors. Skin perforation was most often detected in the reconstruction plate subgroup, with low BMI and total radiation dosage being the most relevant risk factors. Microvascular bone flaps were found to have fewer skin perforations overall, and BMI and expected radiation dosage should be considered when choosing a reconstructive technique.