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A study of skin paddle perforators of free fibula osteoseptocutaneous flap in Hospital Universiti Sains Malaysia

Background : Designing a reliable skin paddle in free fibula osteoseptocutaneous flap is critical since the flap is not only recognized for its robust amount of bone, but also provide skin paddle for soft tissue cover in long bone trauma or mandibular neoplasm. Therefore, it is important to ident...

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Main Author: Omar, Farah Hany
Format: Thesis
Language:English
Published: 2017
Subjects:
RD Surgery
Online Access:http://eprints.usm.my/44938/1/Dr.%20Farah%20Hany%20Omar-24%20pages.pdf
http://eprints.usm.my/44938/
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spelling my.usm.eprints.44938 http://eprints.usm.my/44938/ A study of skin paddle perforators of free fibula osteoseptocutaneous flap in Hospital Universiti Sains Malaysia Omar, Farah Hany RD Surgery Background : Designing a reliable skin paddle in free fibula osteoseptocutaneous flap is critical since the flap is not only recognized for its robust amount of bone, but also provide skin paddle for soft tissue cover in long bone trauma or mandibular neoplasm. Therefore, it is important to identify the perforators and the courses to ensure the skin paddle perfusion. This study was to analyse our 17 years experiences of skin paddle perforator of free fibula osteoseptocutaneous flap in Hospital Universiti Sains Malaysia. Methodology : Retrospective data collected in all patients that underwent free fibula flap in Hospital Universiti Sains Malaysia, Kelantan from 1998 to 2014. The cases with incomplete data were excluded. The skin paddle perforators of free fibula flap type and courses documented based on anatomic location and recorded into an image guided proforma. Result : There was 156 free fibula cases were done within 17 years period, but only 109 cases were included in this study. There were 305 perforators out of 109 fibula flap. Malignant cases (33.9%) was the highest indication for free fibula flap, followed by benign (27.5%), trauma (22.0%), infection (7.3%) and others (9.2%). Tibia and mandible were the highest bone to be reconstructed, which were 32.1% each. According to leg location, middle third leg has the highest number of perforator distribution (72.8%), followed by upper third of leg (18.0%) and lastly lower third of the leg (9.2%). There were 4 types of perforators that were osteoseptocutaneous, musculocutaneous, septomusculocutaneous and musculoseptocutaneous. Osteoseptocutaneous group was the highest perforator supplying the free fibula skin paddle (40%), followed by musculocutaneous(34.4%), septomusculocutaneous (15.4%) and musculoseptocutaneous (10.2%). Among the upper leg, musulocutaneous perforator group was the highest, (49%). Meanwhile, osteoseptocutaneous perforator group was the highest in both middle (42.3%) and distal (53.5%) leg. Conclusion : A reliable skin paddle would be easily raised over middle and distal zone due to the likelihood of the presence of osteoseptocutaneous perforator. Rarely, there would be anatomical variant that the skin paddle of fibula flap will be supplied by perforator from the posterior tibial artery instead of peroneal artery. 2017 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/44938/1/Dr.%20Farah%20Hany%20Omar-24%20pages.pdf Omar, Farah Hany (2017) A study of skin paddle perforators of free fibula osteoseptocutaneous flap in Hospital Universiti Sains Malaysia. Masters thesis, Universiti Sains Malaysia.
institution Universiti Sains Malaysia
building Hamzah Sendut Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Sains Malaysia
content_source USM Institutional Repository
url_provider http://eprints.usm.my/
language English
topic RD Surgery
spellingShingle RD Surgery
Omar, Farah Hany
A study of skin paddle perforators of free fibula osteoseptocutaneous flap in Hospital Universiti Sains Malaysia
description Background : Designing a reliable skin paddle in free fibula osteoseptocutaneous flap is critical since the flap is not only recognized for its robust amount of bone, but also provide skin paddle for soft tissue cover in long bone trauma or mandibular neoplasm. Therefore, it is important to identify the perforators and the courses to ensure the skin paddle perfusion. This study was to analyse our 17 years experiences of skin paddle perforator of free fibula osteoseptocutaneous flap in Hospital Universiti Sains Malaysia. Methodology : Retrospective data collected in all patients that underwent free fibula flap in Hospital Universiti Sains Malaysia, Kelantan from 1998 to 2014. The cases with incomplete data were excluded. The skin paddle perforators of free fibula flap type and courses documented based on anatomic location and recorded into an image guided proforma. Result : There was 156 free fibula cases were done within 17 years period, but only 109 cases were included in this study. There were 305 perforators out of 109 fibula flap. Malignant cases (33.9%) was the highest indication for free fibula flap, followed by benign (27.5%), trauma (22.0%), infection (7.3%) and others (9.2%). Tibia and mandible were the highest bone to be reconstructed, which were 32.1% each. According to leg location, middle third leg has the highest number of perforator distribution (72.8%), followed by upper third of leg (18.0%) and lastly lower third of the leg (9.2%). There were 4 types of perforators that were osteoseptocutaneous, musculocutaneous, septomusculocutaneous and musculoseptocutaneous. Osteoseptocutaneous group was the highest perforator supplying the free fibula skin paddle (40%), followed by musculocutaneous(34.4%), septomusculocutaneous (15.4%) and musculoseptocutaneous (10.2%). Among the upper leg, musulocutaneous perforator group was the highest, (49%). Meanwhile, osteoseptocutaneous perforator group was the highest in both middle (42.3%) and distal (53.5%) leg. Conclusion : A reliable skin paddle would be easily raised over middle and distal zone due to the likelihood of the presence of osteoseptocutaneous perforator. Rarely, there would be anatomical variant that the skin paddle of fibula flap will be supplied by perforator from the posterior tibial artery instead of peroneal artery.
format Thesis
author Omar, Farah Hany
author_facet Omar, Farah Hany
author_sort Omar, Farah Hany
title A study of skin paddle perforators of free fibula osteoseptocutaneous flap in Hospital Universiti Sains Malaysia
title_short A study of skin paddle perforators of free fibula osteoseptocutaneous flap in Hospital Universiti Sains Malaysia
title_full A study of skin paddle perforators of free fibula osteoseptocutaneous flap in Hospital Universiti Sains Malaysia
title_fullStr A study of skin paddle perforators of free fibula osteoseptocutaneous flap in Hospital Universiti Sains Malaysia
title_full_unstemmed A study of skin paddle perforators of free fibula osteoseptocutaneous flap in Hospital Universiti Sains Malaysia
title_sort study of skin paddle perforators of free fibula osteoseptocutaneous flap in hospital universiti sains malaysia
publishDate 2017
url http://eprints.usm.my/44938/1/Dr.%20Farah%20Hany%20Omar-24%20pages.pdf
http://eprints.usm.my/44938/
_version_ 1681490159510487040
score 13.211869

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