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Anchored sutures for fixation of the anterolateral thigh flap and prevention of orocutaneous fistula in oral and oropharyngeal cancer reconstruction

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Abstract

Objective

This study aims to assess the efficacy of anchored sutures (AS) in securing the anterolateral thigh (ALT) flap during oral and oropharyngeal reconstructions, and its impact on the occurrence of orocutaneous fistula (OCF).

Materials and Methods

A retrospective study was performed on patients who underwent ALT flap reconstruction in our department in the year 2022. The patients were divided into two groups based on whether the AS technique was used. The incidence of OCF was compared between the two groups, and AS-related complications were reported. Fisher's exact test was employed to assess the differences in baseline characteristics and the incidence of OCF between the two groups.

Results

The study included 214 patients, with 156 in the conventional suture (CS) group and 58 in the AS group. The incidence of OCF in the AS group was significantly lower compared to that in the CS group (P = 0.039). However, there was a weak correlation between OCF and the AS technique (φ = -0.149). Among the 58 cases in the AS group, three (5.17%) experienced AS-related granuloma (ASRG) as complications.

Conclusion

The use of ALT flap reconstruction with the AS technique reduces the incidence of OCF; however, ASRG may be a potential complication.

Clinical relevance

This study demonstrates the effectiveness of AS technique in securing ALT flaps, leading to a decreased risk of OCF in oral and oropharyngeal defect reconstruction.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Abbreviations

ALT:

Anterolateral thigh

AS:

Anchored suture

ASRG:

Anchored suture-related granuloma

CI:

Confidence interval

CS:

Conventional suture

HE:

Hematoxylin-eosin

IHC:

Immunohistochemistry

NPWT:

Negative pressure wound therapy

OCF:

Orocutaneous fistula

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Acknowledgements

The authors thank all our colleagues who provided assistance during the current study.

Funding

This work was supported by the National Natural Science Foundation of China [82002893].

Author information

Authors and Affiliations

  1. Department of Stomatology Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Pengfei Xin, Chunming Huang, Xu Qin & Chuanyu Hu

  2. School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Pengfei Xin, Chunming Huang, Xu Qin & Chuanyu Hu

  3. Department of Stomatology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China

    Pengfei Xin

  4. Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China

    Chunming Huang, Xu Qin & Chuanyu Hu

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Pengfei Xin, Chunming Huang, and Xu Qin. The first draft of the manuscript was written by Pengfei Xin and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Chuanyu Hu.

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Competing Interests

The authors declare no competing interests.

Ethics Approval and Consent to Participate

Written informed consent was obtained from all patients, and the study has been reviewed and approved by the Ethics committee of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.

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Xin, P., Huang, C., Qin, X. et al. Anchored sutures for fixation of the anterolateral thigh flap and prevention of orocutaneous fistula in oral and oropharyngeal cancer reconstruction. Clin Oral Invest 27, 6537–6545 (2023). https://doi.org/10.1007/s00784-023-05259-w

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