Unleashing the potency of multi-segmental DCIA flap in mandibular reconstruction with the aid of virtual surgery-A retrospective cohort study

作     者：Lin, Hao Deng, Weiwei Zhang, Linzhou Ge, Zhixiang Ma, Chunyue Wu, Tianfu Liu, Bing 

作者机构：Wuhan Univ Sch & Hosp Stomatol Key Lab Oral Biomed Minist EducHubei Key Lab StomatolState Key Lab O Wuhan Peoples R China Wuhan Univ Sch & Hosp Stomatol Dept Oral & Maxillofacial Head Neck Oncol Wuhan Peoples R China Wuhan Joye Appl 3D Technol Co Ltd Wuhan Peoples R China Shanghai Jiao Tong Univ Peoples Hosp 9 Natl Ctr Stomatol Dept Oral & Maxillofacial Head & Neck OncolSch Me 639 Zhi Zao Ju Rd Shanghai 200011 Peoples R China 

出 版 物：《JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY》 (J. Cranio-Maxillofac. Surg.)

年 卷 期：2025年第53卷第5期

页      面：484-490页

核心收录：

学科分类：1003[医学-口腔医学] 1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：Health Commission of Hubei Province scientific research project [WJ2021M179, WJ2021M175] Natural Science Foundation of Wuhan Postdoctoral fellowship program of CPSF [GZC20241270] 

主　　题：Mandibular reconstruction DCIA flap Multi-segmental design Reconstruction algorithm 

摘      要：Although the deep circumflex iliac artery (DCIA) flap is a mainstay in mandibular reconstruction, its multisegmental utilization is infrequently reported, primarily due to concerns regarding the variable cutaneous component and potentially inadequate vascular supply to multi-block segments. This retrospective study analyzed the outcomes of 86 patients undergoing mandibular reconstruction with multi-segmental DCIA flaps, compared to 167 patients who received conventional single-segmental flaps. The survival rate for multisegmental flaps was comparable to that of single-segmental flaps (100% vs. 98.2%, p = 0.553). Multisegmental flaps were used to reconstruct longer bony defects (median: 9 cm vs. 6.5 cm, p 0.001). Despite the longer operation times in the multi-segmental group (368.8 vs. 326.8 min, p 0.001), there was no significant increase in the incidence of surgical complications. Furthermore, postoperative QoL and Harris Hip scores did not show significant differences, despite the increased graft lengths and segmentation in the multisegmental group. The study underscores the underrecognized efficacy of multi-segmental DCIA flaps in complex mandibular reconstructions, particularly for specific types of defects such as Brown III, Brown I (Ic), and Brown II (IIc), which can be effectively and reliably reconstructed with the aid of virtual surgical techniques. This research also confirms that concerns regarding soft tissue management with multi-segmental DCIA flaps can be effectively addressed.