{"title":"Reduction of ischemic time using the pull-through technique for scapular free flap.","authors":"Yoshio Ohyama, Kazuki Hasegawa, Narikazu Uzawa, Tomokazu Sawada, Michio Sano, Masashi Yamashiro, Yasuyuki Michi, Yoshinori Inaba, Kunihiro Myo, Takuya Iwasaki, Masahiko Terauchi, Tetsuya Yoda","doi":"10.1007/s10006-024-01323-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Current scapular free flap (SFF) harvest in mandibular reconstruction often requires repositioning, hindering simultaneous harvest and resection and potentially increasing ischemic time. This study evaluated the efficacy of the pull-through technique (PTT) for SFF harvest, aiming to reduce ischemic time during mandibular segmental resection.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 24 patients who underwent mandibular reconstruction using SFF at two maxillofacial surgery departments between January 2015 and May 2022. In total, 13 patients received PTT, while the remaining 11 underwent non-PTT. Demographic and clinical data were collected, including age, sex, diagnosis, resected mandibular segments, operative time, and ischemic time. Statistical analysis was performed to compare these variables between the PTT and non-PTT groups.</p><p><strong>Results: </strong>The study found no significant differences between the groups in terms of age, sex, diagnosis, number of resected segments, or total operative time. However, ischemic time was significantly shorter in the PTT group than in the non-PTT group. PTT also allowed for minimal position changes during surgery compared with non-PTT.</p><p><strong>Conclusion: </strong>Our study investigated the impact of the PTT on SFF reconstruction during mandibular segmental resection. We found that utilizing PTT-SFF significantly reduced ischemic time compared with the traditional method. This technique offers a potential advantage by facilitating stable blood flow visualization and potentially improving flap viability.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":"29 1","pages":"25"},"PeriodicalIF":1.7000,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oral and Maxillofacial Surgery-Heidelberg","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s10006-024-01323-1","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Current scapular free flap (SFF) harvest in mandibular reconstruction often requires repositioning, hindering simultaneous harvest and resection and potentially increasing ischemic time. This study evaluated the efficacy of the pull-through technique (PTT) for SFF harvest, aiming to reduce ischemic time during mandibular segmental resection.
Methods: A retrospective analysis was conducted on 24 patients who underwent mandibular reconstruction using SFF at two maxillofacial surgery departments between January 2015 and May 2022. In total, 13 patients received PTT, while the remaining 11 underwent non-PTT. Demographic and clinical data were collected, including age, sex, diagnosis, resected mandibular segments, operative time, and ischemic time. Statistical analysis was performed to compare these variables between the PTT and non-PTT groups.
Results: The study found no significant differences between the groups in terms of age, sex, diagnosis, number of resected segments, or total operative time. However, ischemic time was significantly shorter in the PTT group than in the non-PTT group. PTT also allowed for minimal position changes during surgery compared with non-PTT.
Conclusion: Our study investigated the impact of the PTT on SFF reconstruction during mandibular segmental resection. We found that utilizing PTT-SFF significantly reduced ischemic time compared with the traditional method. This technique offers a potential advantage by facilitating stable blood flow visualization and potentially improving flap viability.
期刊介绍：
Oral & Maxillofacial Surgery founded as Mund-, Kiefer- und Gesichtschirurgie is a peer-reviewed online journal. It is designed for clinicians as well as researchers.The quarterly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery and interdisciplinary aspects of cranial, facial and oral diseases and their management. The journal publishes papers of the highest scientific merit and widest possible scope on work in oral and maxillofacial surgery as well as supporting specialties. Practice-oriented articles help improve the methods used in oral and maxillofacial surgery.Every aspect of oral and maxillofacial surgery is fully covered through a range of invited review articles, clinical and research articles, technical notes, abstracts, and case reports. Specific topics are: aesthetic facial surgery, clinical pathology, computer-assisted surgery, congenital and craniofacial deformities, dentoalveolar surgery, head and neck oncology, implant dentistry, oral medicine, orthognathic surgery, reconstructive surgery, skull base surgery, TMJ and trauma.Time-limited reviewing and electronic processing allow to publish articles as fast as possible. Accepted articles are rapidly accessible online.Clinical studies submitted for publication have to include a declaration that they have been approved by an ethical committee according to the World Medical Association Declaration of Helsinki 1964 (last amendment during the 52nd World Medical Association General Assembly, Edinburgh, Scotland, October 2000). Experimental animal studies have to be carried out according to the principles of laboratory animal care (NIH publication No 86-23, revised 1985).
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