Dental Silicone-based Surgical Guides to Harvest the Chimeric Scapular Flap: Preventing Iatrogenic Vascular Injury

Matsui, Chihiro and Escandón, Joseph M. and Mohammad, Arbab and Tanaka, Takakuni and Sasaki, Masashi and Myo, May Me and Mon, Le Yu and Cho Thein, Yi Yi and Mizuno, Hiroshi (2022) Dental Silicone-based Surgical Guides to Harvest the Chimeric Scapular Flap: Preventing Iatrogenic Vascular Injury. Plastic and Reconstructive Surgery - Global Open, 10 (6). e4337. ISSN 2169-7574

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Abstract

Summary: The angular branch of the thoracodorsal artery and the periosteal branches of the circumflex scapular artery can be easily injured while harvesting a chimeric scapular flap. Thus, we reported the use of 3D printed scapular models using CT angiography to prepare inexpensive surgical guides from autoclavable dental silicone impressions for scapular flap harvest. Mandibular and scapular models were prepared using a 3D printer for 11 patients undergoing chimeric scapular flap transfer following mandibular resection. During preoperative simulation surgery, we molded dental silicone accordingly with scapular models to produce surgical cutting guides. Six men (54.5%) and five women (45.5%) were included. The average age of patients was 65.4 years. Fourteen bone units were reconstructed as three patients needed two bone segments (27.3%) whereas eight patients required reconstruction of one bone segment (72.7%). The mean flap harvest time and total surgical time were 52.1 min and 633.8 min, respectively. The mean duration for osteotomies and bone plate fixation was 26.2 min. The difference between the length of the preoperative surgical model (64.92 mm) and the postoperative 3D-CT measurements (64.48 mm) was not statistically significant (0.95 mm, P = 0.397). No injuries were caused to the angular and periosteal vessels. Four patients exhibited donor-site seroma (36.4%). The cost of the dental silicone for surgical guide was only $5 per patient. Dental silicone-based surgical guides help minimize the risk of vascular injury while harvesting chimeric scapular flaps. The osteotomies were performed with precision and in a time-efficient manner. © 2022 Elsevier B.V., All rights reserved.

Item Type: Article
Subjects: Dentistry > Oral Surgery
Divisions: Medicine > Aarupadai Veedu Medical College and Hospital, Puducherry
Depositing User: Unnamed user with email techsupport@mosys.org
Last Modified: 02 Dec 2025 09:14
URI: https://vmuir.mosys.org/id/eprint/2775

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