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Cirugía Plástica Ibero-Latinoamericana
On-line version ISSN 1989-2055Print version ISSN 0376-7892
Abstract
MENDIETA ESPINOSA, Mauricio et al. Submental flap: clinical applications and variations in the design. Cir. plást. iberolatinoam. [online]. 2019, vol.45, n.4, pp.395-404. Epub Mar 02, 2020. ISSN 1989-2055. https://dx.doi.org/10.4321/s0376-78922019000400009.
Background and objective
The submental flap has been previously described as an alternative for the coverage of cutaneous defects or the middle and lower thirds of the face, as well as a vascularized lymph node flap for the treatment of secondary lymphedema of the extremities.
Our goal is to justify its clinical application, and the use of the variants of the components of the flap and design, either with the inclusion of the digastric muscle, submental perforator, reverse flow or microvascular flap, with minimal complications.
Methods
We present a series of 8 patients in which a submental flap was performed to restore cutaneous defects of the middle and lower thirds of the face, and the treatment of secondary lymphedema of the upper extremity. Flaps dimensions were between 40 to 84 cm2 (average of 62 cm2).
The flap was designed as submental pedicled flap in 4 cases (50%), with preservation of digastric muscle based on a submental perforator in 2 cases, reverse flow submental flap in 1 case, and as a vascularized submental lymph node transfer flap y 1 case.
Results
Complications occurred in 1 of the cases, presented as a partial necrosis of a 30% of a submental reverse flow flap, which healed by secondary intention. Donor site was closed primarily in all the cases.
Conclusions
In our opinion, the submental flap is a good choice for the coverage of cutaneous defects of the middle and lower face, providing a thickness, texture and color similar to neighboring tissues, as well as an alternative for the treatment of secondary lymphedema of the upper extremity.
Keywords : Submental flap; Head and neck reconstruction; Local flaps.