The paper reviewed the effectiveness and reliability of skin paddles of free fibula flaps in the reconstruction of maxillofacial defects.Methods :Fifty-five consecutive free fibula osteocutaneous flap transfers performed fromJune 21 , 1999 to Oc2 tober 31 , 2000 were reviewed. The skin paddles of each flap were analyzed in terms of surgical design , blood supply , size , recon2 struction location , and survival. Results :Fifty- seven skin paddles were used for the 55 free fibula flaps (double skin paddles for 2 flaps) , 37 were nurtured by one perforator , 18 by two and two by 3 perforators. Twenty-eight skin paddles were used for intraoral reconstruction , 7 for extraoral reconstruction , 1 for both intraoral and extraoral reconstruction , 2 for soft tissue augmentation , and the remaining 19 were simply used as windowfor monitoring the blood flow of fibula flap. One free fibula flap with one skin paddle was lost because of venous thrombosis , and the other 54 flaps survived completely , with 100 % survival of 56 skin paddles.Con2 clusion :The skin paddle of free fibula flap is safe and reliable. It can be used for all kinds of soft tissue reconstruction , as well as window for monitoring the blood flow of fibula flap after operation.
