Sudden shrinkage of free rectus abdominis musculocutaneous flap 15 years after maxilla reconstruction

Yasushi Mochizuki; Kazuki Ueda; Masaru Horikiri; Akiyoshi Kajikawa

doi:10.1016/j.jpra.2017.11.001

Sudden shrinkage of free rectus abdominis musculocutaneous flap 15 years after maxilla reconstruction

JPRAS Open. 2017 Dec 2:15:46-50. doi: 10.1016/j.jpra.2017.11.001. eCollection 2018 Mar.

Authors

Yasushi Mochizuki¹, Kazuki Ueda¹, Masaru Horikiri¹, Akiyoshi Kajikawa²

Affiliations

¹ Department of Plastic and Reconstructive Surgery, Fukushima Medical University, Fukushima, Japan.
² Department of Plastic and Reconstructive Surgery, St. Marianna Medical University, Kanagawa, Japan.

Abstract

A 60-year-old male displayed sudden shrinkage of a left free rectus abdominis musculocutaneous flap, which had been grafted to his left maxilla 15 years previously. No post-reconstructive irradiation had been performed, and no late occlusion of the vascular anastomosis, local infection, recurrence of the maxillary cancer, or body weight loss was observed. However, the shrinkage amounted to approximately 50%. This is considerably more than previously reported cases of shrinkage of various free flaps, which ranged between 10% and 25%. The resultant depression was successfully augmented with a right free deep inferior epigastric artery perforator flap. The residual fat volume of the previously grafted shrunken flap was revealed to be compatible with that of the newly harvested contralateral perforator flap. Thus, the volume of the previously grafted flap may reflect the status of the intact contralateral donor site, although the mechanism of sudden flap shrinkage is unclear.

Keywords: Deep inferior epigastric artery perforator flap; Free flap; Head and neck reconstruction; Rectus abdominis musculocutaneous flap; Volume change.

Publication types

Case Reports