CASE REPORTS   

Minerva Stomatologica 2008 January-February;57(1-2):53-7

Copyright © 2007 EDIZIONI MINERVA MEDICA

language: English, Italian

Intermediate short-term tourniquet use during the preparation of a free vascularised fibula flap for mandibular reconstruction. A case report

Thiele O. C. ¹, Scuto I. ¹, Allamprese F. ¹, Freier K. ¹, Hoepner C. ¹, Simon R. ²

¹ Department of Oral and Maxillofacial Surgery University Hospital, Heidelberg, Germany 2 Orthopaedic University Hospital Heidelberg, Germany

First described by Taylor et al. in 1975, the fibula flap is well established as a universal method for reconstruction of defects in several medical fields. Mostly a tourniquet is kept on during the whole procedure of harvesting the fibula flap. In some hospitals the operation is performed without tourniquet. The outcome is mostly described as successful, but functional impairment and donor site morbidity should not be neglected and severe complications are not frequently reported. In this article we describe a modification of the standard harvesting techniques to minimise the ischaemia time of the flap as well as the danger of severe blood loss. The tourniquet was only activated during the final disconnection of the fibular artery and was released immediately after the successful harvesting of the fibula flap. This method combines the safety of a tourniquet during the critical disconnection procedure and the advantages of a long perfusion of the donor site and the graft.