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Vol. 85. Issue 1.
Pages 40-44 (January 2009)
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Vol. 85. Issue 1.
Pages 40-44 (January 2009)
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Double vascular pedicle iliac crest flap
Colgajo de cresta ilíaca de doble pedículo vascular
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Javier Rodríguez Fernándeza,
Corresponding author
javier.doctork@gmail.com

Author for correspondence.
, Mario Mateos Micasa, Ramón Galána, Pedro Cobosb, Margarita Jovéb, Laura Aguilerac, Olga Vázqueza, Jens Mommsena, Gabriel Fortezaa, Verónica Pierab
a Servicio de Cirugía Maxilofacial, Hospital Universitario Joan XXIII, Tarragona, Spain
b Unidad de Anatomía Humana, Facultad de Medicina y Ciencias de la Salud, Universidad Rovira i Vigili, Reus, Tarragona, Spain
c Unidad de Rehabilitación y Medicina Física, HUGTP, Badalona, Barcelona, Spain
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Abstract
Introduction

The iliac crest flap is commonly used in reconstructions of the head and neck. The vascularisation of this region depends on the deep circumflex iliac artery and vein (ACIP/VCIP).The present study describes for the first time, the simultaneous use of the deep and superficial circumflex iliac systems to obtain an iliac crest flap for head and neck reconstructions.

Material and method

Ten inguinal regions were dissected in 5 cadavers in the Human Anatomy and Embryology Unit of the Faculty of Medicine of the Rovira i Virgili University (Reus, Spain). In the period 2005–2007, 3 patients required mandibular reconstruction with a microvascularised iliac crest osteocutaneous flap at the Maxillofacial Surgery Unit of the Joan XXIII University Hospital (Tarragona, Spain).

Results

The 3 cases showed a favourable outcome. This “supercharging” variation guarantees the perfusion to the skin flap, provides a better3-dimensional arrangement of the soft tissue and lowers the morbidity at the donor site, as much less internal oblique muscle cuff is harvested

Conclusions

This technique may be of great interest in the reconstruction of complex maxillofacial defects instead of having to carry out a vascular dissection and its extra anastomosis.

Keywords:
Free flap
Supercharged
Head and neck reconstruction
Surgery
Resumen
Introducción

El colgajo de cresta ilíaca (CCI) es uno de los utilizados con mayor frecuencia en la reconstrucción facial. Su vascularización depende de los vasos circunflejos ilíacos profundos (ACIP, VCIP). Este trabajo describe, por primera vez, la posibilidad de doble irrigación de la isla cutánea del CCI incluyendo el sistema circunflejo ilíaco superficial para la reconstrucción de cabeza y cuello.

Material y método

Se diseccionaron 10 regiones inguinales de 5 cadáveres en el Departamento de Anatomía de la Facultad de Medicina Rovira i Virgili de Reus (Tarragona). En el periodo 2005–2007, 3 pacientes fueron intervenidos en el Servicio de Cirugía Maxilofacial del Hospital Joan XXIII de Tarragona, requiriendo un colgajo osteomiocutáneo microvascularizado de cresta ilíaca.

Resultados

Los 3 casos clínicos mostraron una evolución satisfactoria. Esta técnica proporciona una mayor vascularización del colgajo y una mayor disponibilidad tridimensional e implica menor morbilidad de la zona donante, ya que se necesita tallar menos cantidad de oblicuo pues la irrigación de los vasos perforantes no depende de la ACIP.

Conclusiones

Esta variación técnica del colgajo de cresta ilíaca puede sernos de gran utilidad en la reconstrucción de defectos complejos maxilofaciales a cambio de realizar una disección vascular y su anastomosis extra.

Palabras clave:
Colgajo de cresta ilíaca
Microvascularizado
Reconstrucción de cabeza y cuello
Cirugía
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Copyright © 2009. Asociación Española de Cirujanos
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