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[Free Flap 901-P7] Surgery: Custom Fibula Inset & Microvascular Anastomosis (Second stage surgery after GSW to Lower Face with Mandible Avulsion)

0:00
Preview Surgery
0:35
Fibula Flap Disconnect
1:03
Determine better VCs
1:34
Disconnect Peroneal Artery
1:45
Flush flap with heparinzed saline
2:09
Increase vessel reach by detaching skin flap
2:47
Secure plate to native mandible
3:48
Begin micro
4:05
Donor vessel thrombus management
5:56
Determine vessel orientations & sequence of anastamosis
7:11
First vein anastamosis using doppler coupler
8:48
Artery Anastamosis
12:05
Confirm adequate blood flow by milking vessels
13:00
Second vein anastamosis
14:25
Flap Monitoring with Vein Dopplers, Transduction
15:13
Arterial Doppler Monitoring
16:07
Padding flap vessels with Gelfoam
16:25
Draping Plate & Fibula with deepithelialized skin flap
17:14
JP drain placement
17:58
Closing neck on flap side first
18:31
Postop Imaging

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Procedures performed:

  1. Fibula Flap Inset in the Head & Neck
  2. Microanastamosis of fibula flap  to facial artery, facial vein and EJV
  3. Neck closure
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