Application of the Deep Circumflex Iliac Perforator Fascial Flap with Iliac Crest for the Reconstruction of Mandibular Defect

Objectives: To preliminary study the Deep Circumflex Iliac Perforator (DCIP) fascial flap with iliac crest for the reconstruction of mandibular defect following surgical resection.

Methods: Eight patients with osteosarcoma, ameloblastoma, ossifying fibroma, and squamous cell carcinoma underwent mandibular resection and free DCIP fascial flap with iliac crest reconstruction in our department between 2016 and 2017. An incision is made above the anterior superior iliac spine to identify the origin of the deep circumflex iliac artery, dissection is performed following the course of the deep circumflex artery, upward into the external oblique muscle. The perforator is usually 2cm above the iliac crest and 6cm posterior to the anterior superior iliac crest. A fascial flap is designed superficial the external oblique muscle, including the dominant perforator. The iliac crest and fascial flap is harvested catering to the actual need. The length of iliac crest ranged from 6 to 12 cm, and the size of facial flap from 2 x 3 to 4 x 6 cm². The DCIP fascial flap with iliac crest is transferred to the mandibular defect.

Results: One flap loss occurred related to vascular thrombosis, the other seven patients DCIP fascial flap with iliac crest are survived. Two of seven patients, which soft tissue defect related the buccal mucosa and the floor of mouth is lead to delay healing. All of the fascial flaps are transforming into mucosa after one month of the operation. Donor-site morbidity is moderate. The seven patients which DCIP fascial flap with iliac crest is surviving, are satisfied with their functional and aesthetic results.

Conclusions: The DCIP fascial flap with iliac crest is matched to the mandibular defect, which makes it an ideal choice for mandibular reconstruction.