case_images: PMC6161216_01
case_images: Composite oral cavity defect. Through-and-through defect following composite mandibular resection and resection of the entire chin pad.
case_images: eplasty18e24_fig1.jpg
case_images: PMC6161216_01_eplasty18e24_fig1.jpg
case_images: F1
case_images: The patient was a 65-year-old man with recurrent oral cavity squamous cell carcinoma who underwent a composite resection of the floor of mouth, the mandible from angle to angle, and the entire chin pad (Fig 1).
case_images: Simultaneous harvest of anterior tibial perforator free flap and fibular osteocutaneous free flap. Anterior tibial perforator supplying the anterior border of skin paddle.
case_images: eplasty18e24_fig2.jpg
case_images: PMC6161216_01_eplasty18e24_fig2.jpg
case_images: F2
case_images: Once an anterior incision was made, an anterior-lateral perforator supplying the skin paddle was encountered (Fig 2).
case_images: Fibular free flap plated into a reconstruction plate, shown with attached anterior tibial perforator flap (ie, flow-through free flap). Anterior tibial perforator sewn to the distal end of the peroneal artery, microvascular anastomosis for flow-through free flap performed in the leg (short arrow). Vasculature of fibula anastomosed to the right facial artery, the external jugular vein, and a large common facial vein (long arrow).
case_images: eplasty18e24_fig3.jpg
case_images: PMC6161216_01_eplasty18e24_fig3.jpg
case_images: F3
case_images: The pedicle to the anterior tibial perforator was then sewn to the distal ends of the peroneal artery and of one of the venae comitantes (ie, flow-through technique) (Fig 3).
case_images: Inset of fibular flow-through free flap. Reconstruction of composite defect. Blue stitch located at the site of anterior tibial perforator.
case_images: eplasty18e24_fig4.jpg
case_images: PMC6161216_01_eplasty18e24_fig4.jpg
case_images: F4
case_images: The peroneal perforator was centered in the skin paddle for the floor of mouth reconstruction, and the tibial perforator was centered in the skin paddle of the chin (Fig 4).