ArticleMedicina oral, patologia oral y cirugia bucal2026
Outcomes comparison between fibula and DCIA free flaps in head and neck reconstructive surgery: Implications for donor site selection.
Article in Medicina oral, patologia oral y cirugia bucal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDonor site selection for bone tissue reconstruction in head and neck surgery has remained a matter of debate since the advent of microsurgical techniques. Both the fibula and the deep circumflex iliac artery (DCIA) free flaps offer specific advantages but also present distinct morbidity profiles that must be considered to provide optimized and personalized reconstructive treatment for each patient. MATERIAL AND
methodsA retrospective morbidity analysis was conducted on 66 osseous free flaps (fibula and DCIA) used for head and neck reconstructive surgery at Ramón y Cajal University Hospital over a 6-year period (2018-2024). Surgical variables, as well as local and systemic complications, were analyzed.
resultsReconstruction with the DCIA free flap was associated with a threefold higher risk of developing systemic infections not related to surgical site (47.37% vs. 21.28%; OR=3.33; 95% CI=1.07-10.41) compared with the fibula free flap. No statistically significant differences were observed between the two groups regarding free flap failure, surgical site infections, postoperative bleeding, microvascular complications, or donor site morbidity.
conclusionsthe DCIA free flap may be associated with a higher risk of systemic infections. Therefore, for patients with predisposing factors for systemic infections, the fibula free flap might represent a safer donor site. These findings could help refine donor site selection and improve individualized planning in head and neck reconstructive surgery.
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