{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T23:18:54Z","timestamp":1778282334976,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,3,30]],"date-time":"2018-03-30T00:00:00Z","timestamp":1522368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To reconstruct extensive head and neck defects usually necessitates double free flaps, which require a time\u2010and\u2010manpower\u2010consuming surgical procedure. We present using a single fibula or peroneal flap with the novel design of obliquely\u2010arranged double skin paddles to reconstruct an extensive head and neck defect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 1998 to 2016, eight patients with the age of 52.25 (35\u201371) years old had extensive head and neck defects after oral cancer ablation. All of the defects were through and through with the size of 16.25 (12\u201324) cm \u00d7 8.8 (4.5\u201311) cm. Six of the defects were due to buccal cancer. One was due to tongue cancer, and another one was due to gingiva cancer. All the defects were reconstructed with obliquely\u2010arranged double\u2010paddle free fibula or peroneal flaps. The long axis of the skin paddles was arranged at certain angle (30\u201345 degrees) to the long axis of lower leg, and the two separate skin paddles were used as the form of island flaps by isolating the cutaneous perforators to create a true chimeric flap.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The skin paddle sizes were 14 cm \u00d7 3 cm\u201324 cm \u00d7 11 cm and 9.5 cm \u00d7 4.5 cm\u201313 cm \u00d7 8 cm. The average length of harvested fibula was 19 (10\u201330) cm. All of the eight flaps survived without obvious donor site morbidity. One patient had partial skin necrosis over recipient site, requiring surgical debridements and closure. One patient had superficial necrosis over the edge of outer skin paddle, which healed spontaneously. After the follow\u2010up periods of 1 month to 3 year and 8 months, two patients died of sepsis. Six of them could resume soft diet and had no saliva drooling. The remaining two remained nasogastric diet and had saliva drooling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>With the design of obliquely\u2010arranged double paddles, we may maximize the harvested skin area of lateral lower leg to reconstruct an extensive head and neck defect with a single free flap.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30322","type":"journal-article","created":{"date-parts":[[2018,3,30]],"date-time":"2018-03-30T08:14:28Z","timestamp":1522397668000},"page":"108-114","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Obliquely\u2010arranged double skin paddles: A novel design to reconstruct extensive head and neck defects with a single fibula or peroneal flap"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4499-0881","authenticated-orcid":false,"given":"Ying\u2010Sheng","family":"Lin","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital Kaohsiung Taiwan"},{"name":"Division of Plastic and Reconstructive Surgery National Taiwan University Hospital Yulin Branch Yulin County Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen\u2010Chung","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital Kaohsiung Taiwan"},{"name":"College of Medicine National Yang\u2010Ming University Taipei Taiwan"},{"name":"National Defense Medical Center Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuan\u2010Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Plastic and 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