Digitally reconstruct severe trauma-induced oro-maxillofacial defects with free vascularised composite tissue flaps

Abstract The aim of this study was to outlined the characteristics of severe trauma-induced oro-maxillofacial defects and explored the application of microsurgical reconstruction of these defects by selecting appropriate free vascularised composite tissue flaps. A retrospective analysis was performed in 11 cases with severe trauma-induced oro-maxillofacial defects from 2005 to 2018, All cases were reconstructed with free vascularised composite flaps using a supermicro- or micro-surgical and digital technology. This study consisted of 11 patients (8 men, 3 women) with a median age of 28 years, ranging 6–64 years. Patients with long-standing trauma experienced severe scars and displacements. The trauma-induced oro-maxillofacial defects ranged in size from 4.0×5.0 cm2 to 7×15 cm2. Six radial forearm flaps, three fibular osteocutaneous flaps, a lateral thoracic flap, and an anterolateral thigh flap were harvested individually. All patients were treated effectively and followed up for over two years, with a 100% survival rate of these free vascularised composite tissue flaps. No uncontrollable complications occurred, and all patients were satisfied with the postoperative shape and function. So the trauma-induced oro-maxillofacial defects display unique features, and microsurgical techniques play an important role in the reconstruction of shapes and function. In addition, some patients may need multi-stage surgeries to aesthetic refinement.