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Technique for transfer of a template in free flap design
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British Journal of Oral and Maxillofacial Surgery 48 (2010) 557
Technical note
Technique for transfer of a template in free flap design Vikas Sood ∗ , Alok Misra, Ian Brown, John Devine Regional Maxillofacial Unit, Southern General Hospital, 1345 Govan Road, Glasgow, G51 4TF, UK Accepted 15 October 2009 Available online 18 November 2009 Keywords: Free flap design; Template; Oro-pharyngeal reconstruction
We describe a method for transferring the template of a bespoke free flap from recipient to donor sites. Resection of oropharyngeal tumours often results in a complex three-dimensional defect the size of which can be difficult to predict until the resection has taken place. Reconstruction is best addressed using a bespoke flap design that can be drawn on sterile paper by the resection team, and then cut out to form a two-dimensional template. However, as the resection site may potentially be contaminated with tumour cells and micro-organisms, it cannot be transferred directly to the donor site. Transfer of the non-sterile template to mark out the donor site before preparing and draping the area is one way around the contamination risk, but it is not time efficient and still risks contamination. We have developed a technique in which a template can be transferred between recipient and donor sites in a sterile manner with virtually no risk of bacterial contamination or tumour seeding to the donor site. The bespoke template is designed. Before it is transferred it is placed between two sheets of sterile transparent adhesive dressing to create a template sandwich. The flap team, who are clean from contaminants, hold the first sheet with the adhesive side facing upwards. The template is carefully dropped on to this first sheet by a member of the tumour resection team. The second sheet of the adhesive dressing is then placed on the first sheet, adhesive side down, so the adhesive sides stick together (Fig. 1), which effectively laminates the template to make it sterile. It can then be cut into the correct shape and size by the flap team (Fig. 2), and drawn on to the donor site before flap harvest commences.
∗
Corresponding author. Tel.: +0141 232 7509; fax: +0141 232 7508. E-mail address: [email protected] (V. Sood).
Fig. 1. The template sandwiched between two sheets of sterile transparent adhesive dressing.
Fig. 2. The template ready to be cut out.
0266-4356/$ – see front matter © 2009 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.bjoms.2009.10.016
British Journal of Oral and Maxillofacial Surgery 48 (2010) 557
Technical note
Technique for transfer of a template in free flap design Vikas Sood ∗ , Alok Misra, Ian Brown, John Devine Regional Maxillofacial Unit, Southern General Hospital, 1345 Govan Road, Glasgow, G51 4TF, UK Accepted 15 October 2009 Available online 18 November 2009 Keywords: Free flap design; Template; Oro-pharyngeal reconstruction
We describe a method for transferring the template of a bespoke free flap from recipient to donor sites. Resection of oropharyngeal tumours often results in a complex three-dimensional defect the size of which can be difficult to predict until the resection has taken place. Reconstruction is best addressed using a bespoke flap design that can be drawn on sterile paper by the resection team, and then cut out to form a two-dimensional template. However, as the resection site may potentially be contaminated with tumour cells and micro-organisms, it cannot be transferred directly to the donor site. Transfer of the non-sterile template to mark out the donor site before preparing and draping the area is one way around the contamination risk, but it is not time efficient and still risks contamination. We have developed a technique in which a template can be transferred between recipient and donor sites in a sterile manner with virtually no risk of bacterial contamination or tumour seeding to the donor site. The bespoke template is designed. Before it is transferred it is placed between two sheets of sterile transparent adhesive dressing to create a template sandwich. The flap team, who are clean from contaminants, hold the first sheet with the adhesive side facing upwards. The template is carefully dropped on to this first sheet by a member of the tumour resection team. The second sheet of the adhesive dressing is then placed on the first sheet, adhesive side down, so the adhesive sides stick together (Fig. 1), which effectively laminates the template to make it sterile. It can then be cut into the correct shape and size by the flap team (Fig. 2), and drawn on to the donor site before flap harvest commences.
∗
Corresponding author. Tel.: +0141 232 7509; fax: +0141 232 7508. E-mail address: [email protected] (V. Sood).
Fig. 1. The template sandwiched between two sheets of sterile transparent adhesive dressing.
Fig. 2. The template ready to be cut out.
0266-4356/$ – see front matter © 2009 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.bjoms.2009.10.016