An analysis of the postoperative period in patients with facial defects after reconstructive procedures using a three-stage algorithm and the “Autoplan” software

The purpose of a study: to evaluate the effectiveness of a three-stage algorithm in performing reconstructive procedures in patients with acquired head defects in the postoperative period.

Material and methods. An analysis of patient management in the postoperative period was conducted in 180 patients. Patients were divided into two groups: the main group (100 patients, including 67 men and 33 women) and the control group (80 patients: 62 men and 18 women). The average age in the main group was 47 ± 13, in the control group –(45 ± 12) years old. The surgery in the main group was carried out using a three-stage algorithm and the Autoplan software (state contract of the Ministry of Industry and Trade of the Russian Federation dated 07.04.2014 No. 14411.2049999.19.013 “4.3- Avtoplan-2014”), in the control group – based on generally accepted principles. A comparison was made of the number of postoperative complications, the degree of congruence of the flaps and the recipient wound, and the severity of lymphatic edema as a consequence of trauma to the donor area.

Results. Complications: total flap necrosis – were noted in 8 cases (8%) in the main group and in 10 (12.5%) in the control group; from the recipient wound – in 22 (22%) and 30 cases (37.5%), respectively. In the main group, 14 scapular flaps were used, the average deviation of the bone structures of the flap and the recipient area was (3.2 ± 2.7) mm. When using 42 fibular flaps, the average deviation of the flap and recipient tissues was (2.5 ± 1.1) mm. In the control group, 12 scapular flaps were used, while the average deviation of the structures (6.10 ± 1.66) mm. Among 31 fibular flaps, the average deviation of bone structures was (4.40 ± 1.14) mm. Radial and ALT flaps were not accompanied by the appearance of persistent lymphatic edema of the limb 12 months after surgery, in contrast to the use of the fibular flap.

Conclusion. The use of a three-stage algorithm for performing surgical treatment allows us to reduce the number of postoperative complications and achieve better results in matching the bone structures of the flap and the recipient area, leading to better patient rehabilitation results.

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