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Vascularized thigh free flaps used successfully in orbital exenteration
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 Sara Lally |
PHILADELPHIA — Radical orbital exenteration in cases of extensive orbital malignancies can leave complex defects that require free flap grafts from the arm or leg with microvascular anastomosis, a speaker said here.
"Removal of invasive cancers involving the orbit and surrounding tissue often results in complex defects involving multiple mid-facial sites," Sara Lally, MD, said at the Wills Eye Institute Alumni Conference.
Complete removal of cancerous tumors results in better disease control and prolonged survival but leaves devastating functional and cosmetic effects, she said. In these extensive cases, a vascularized anterolateral thigh free flap harvest that yields a thick flap of more than 200 cm2 may be grafted and thinned later so that the flap does not project beyond the contralateral eye.
Benefits of using vascularized free flaps include the ability to harvest the tissue efficiently with a two-team approach, low donor site morbidity, and reduced risk of exposure and subsequent infection compared with skin grafting, Dr. Lally said.
"In our patients, we have not seen many complications," Dr. Lally said. Two patients were returned to the operating room to drain postoperative hematomas, but there were no flap failures or flap breakdowns, she said.
- Disclosure: Dr. Lally has no relevant financial disclosures.