{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:52:17Z","timestamp":1777686737860,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,4,18]],"date-time":"2017-04-18T00:00:00Z","timestamp":1492473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec><jats:label\/><jats:p><jats:bold>Background:<\/jats:bold> A double island free fibula (DIFF) flap can be used for reconstruction of through\u2010and\u2010through or complex mandibulectomy defects, but prospective studies are lacking.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Prospective analysis of all double skin paddle fibula flaps performed from 2010 to 2016.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Overall, 16 patients underwent reconstruction with a DIFF flap (average age: 59.1 years). One patient, who underwent a DIFF flap and developed osteoradionecrosis, requiring a second flap. Thirteen patients were males, and 7 had a history of smoking, 13 had prior radiation, and 14 had prior chemotherapy. The most common primary pathology was squamous cell carcinoma (<jats:italic>n<\/jats:italic>\u2009=\u200913). Reconstruction using the DIFF was predominantly for mandible reconstruction with one patient undergoing reconstruction following a orbitomaxillectomy. Complications included infection (<jats:italic>n<\/jats:italic>\u2009=\u20092), hematoma (<jats:italic>n<\/jats:italic>\u2009=\u20091), and donor site complications were limited. Two patients developed venous congestion requiring re\u2010exploration, and both flaps were successfully salvaged. One patient lost the external skin paddle requiring a pectoralis muscle flap, and there were no total flap losses.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> The DIFF flap is a reliable option that can reconstruct complex composite defects often obviating the need for a second free flap, thereby decreasing operating time, added donor site morbidity, and the need for additional recipient vessels.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.24647","type":"journal-article","created":{"date-parts":[[2017,4,18]],"date-time":"2017-04-18T21:03:16Z","timestamp":1492549396000},"page":"258-262","source":"Crossref","is-referenced-by-count":26,"title":["Prospective series of reconstruction of complex composite mandibulectomy defects with double island free fibula flap"],"prefix":"10.1002","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1067-9750","authenticated-orcid":false,"given":"Edward I.","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peirong","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,4,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21100"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000722"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182362a9c"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1234023"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1255336"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20540"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000174952.98927.9f"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318262f115"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31818a9afa"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199901000-00008"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31821e7058"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000216"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e3181734f60"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000070981.73721.8D"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24452"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21537"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318221dc2a"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20955"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjso.24647","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.24647","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T10:15:12Z","timestamp":1696500912000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.24647"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,18]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1002\/jso.24647"],"URL":"https:\/\/doi.org\/10.1002\/jso.24647","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,18]]}}}