Clinical study on bone grafting in the mandibular region VIII Reconstruction of mandible using bone graft wrapped in deltopectoral flap: Report of two cases.:VIII Reconstruction of mandible using bone graft wrapped in deltopectoral flap; Report of two cas

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Secondary mandibular reconstructions using osteocutaneous flaps were performed in a 27-and a 64-year-old male patients, who had a mandibular defect with contructure of scar in the surrounding tissue. Primarily, in the first case, an iliac graft and in the second case, a 7th rib graft were wrapped when making a deltopectoral flap, respectively. Secondarily, each osteocutaneous flap was transplanted to the defect for reconstruction of the mandible following deepithelization. In the iliac graft, the mandibular reconstruction was successful, and in the rib graft, it resulted in a pseudoarthrosis due to postoperative infetion and salivary fistula from injury to the parotis gland during operation.<BR>The previous two experiences suggest to us the following: 1) Bone graft wrapped in the deltopectoral flap may maintain blood supply and tolerate postoperative infection. 2) The union between the cutaneous flap and bone graft was stronger in the iliac graft than in the rib one. Because the surface of the rib is flat and covered by the cortical bone, morphologically, its combination force is inferior. 3) This technique is disadvantageous, because it takes much time owing to delays, but it has an advantage of minor damage by operation. 4) For the purpose of fixation of the graft and the mandibular stump, utilization of metal plates or intermaxillary fixation in a term should be performed.
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