Reconstruction of facial defects using facial artery perforator flaps / Mohammed Mohamed Sayed Alazrak ; Supervised Ahmed Adel Nour Eldin , Tarek Ahmed Said , Karima Taher Ismail

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of General Surgery

Facial soft tissue defects can be resulted in different situations; post traumatic, post tumor resection, post contracture release or being an old defect present after management of congenital anomalies or previous surgery. Management modalities range between; skin grafting, local flaps or free flaps. After the era of perforator flaps evoked, different investigators searched the head and neck for valuable perforator suitable for flaps raising to help in reconstruction of defects in the face. In this thesis we have applied facial artery perforators as an arterial support to elevate various designs of flaps. The sample composed of 15male and 10 females aged; 4 to 70 years old (median age; 32.36years). The total surface area reconstructed in this thesis was; 382cm2 (average; 15.28 cm2). 8 cases (32%) done under general anesthesia and 17 cases (68%) under local anesthesia. Transferred tissue composing the FAP flap were ; cutaneous (17 cases), fascial ( 6 cases), muscular (1 case) and mucosal (1case). Complications were encountered in this thesis in four cases (16 %) as venous congestion, tip necrosis and total necrosis. Complete reconstruction in 24 cases (96%) were achieved with satisfactory functional and aesthetic match in the reconstructed regions in one stage, with minimal donor-site morbidity in all patients. The FAP flaps are versatile and allows free style design to match the various facial defects in middle and lower face. It is superior to local flaps allowing wider range of transfer

Issued also as CD