ePlasty: Vol. 13
Reconstruction and Characterization of Composite Mandibular Defects Requiring Double Skin Paddle Fibular Free Flaps
Austin M. Badeau, BA,a and Frederic W.-B. Deleyiannis, MD, MPhil, MPHb

aUniversity of Colorado School of Medicine, Anschutz Medical Campus; and bUniversity of Colorado Hospital & Children's Hospital Colorado, Division of Plastic and Reconstructive Surgery, Departments of Surgery and Otolaryngology, Aurora, Colo

Correspondence: Frederic.deleyiannis@childrenscolorado.org

Objective: Fibular free flaps are the preferred method for reconstruction of composite lateral mandibular defects. This reconstructive technique is limited by the skin paddle's inability to freely rotate when attempting to fill 2 poorly aligned defects. Reconstructive surgeons have been exploring multiple methods of creating 2 independent skin paddles based on the same peroneal blood supply. We present a variation of these techniques. Method: Our patient with a history of squamous cell carcinoma presented with a left retromolar recurrence and osteoradionecrosis of the mandible with a draining anterior sinus tract. The combination of these defects warranted further composite resection with fibular free flap reconstruction. Results: A subperiosteal dissection was performed to create 2 separate septocutaneous skin paddles based on the same peroneal blood supply. This dissection and discard of proximal f .......