Perioperative findings and complications of non-vascularised iliac crest graft harvest: The experience of a Nigerian tertiary hospital.

ABSTRACT

BACKGROUND: The reconstruction of a mandibular defect remains a significant challenge to the reconstructive surgeon. In developing countries like Nigeria, the required facilities and expertise for vascularised graft surgery are not readily available, thus mandibular defects are commonly reconstructed with non-vascularised bone grafts. The aim of this study is to describe the experience with the reconstruction of mandibular defects using non-vascularised iliac crest bone grafts (NVICBG) at a Nigerian tertiary hospital. PATIENTS AND METHODS: This was a descriptive longitudinal study in which data was prospectively collected from patients who had mandibular reconstruction secondary to benign lesions using NVICBG at the University College Hospital, Ibadan, over a 24-month period. Information recorded included demography, cause of mandibular defect, type of mandibular resection, span of defect, peri-operative data, recipient site complications and donor site complications. Patient satisfaction with facial aesthetic outcome was assessed with the use of visual analogue scale score. RESULTS: Twenty patients had mandibular resection and immediate reconstruction with NVICBG. The mean age was 31.61 (+/-11.05) years. Mean span of the defects was 10.65 (+/-2.88) cm. At the recipient site, two patients had extra-oral wound dehiscence and two patients had intra-oral wound dehiscence of which one patient had loss of the graft. Donor site complications noted were seromas and wound dehiscence. Eighteen patients had paraesthesia of the lateral femoral cutaneous nerve. All patients had temporary abnormal gait. The mean duration of abnormal gait was 2.11 weeks (SD +/-0.74). Majority of the patients were satisfied with the aesthetic outcome. CONCLUSION: NVICBG, though limited in its versatility has satisfactory aesthetic outcome with relatively few complications. It appears that this method of reconstruction can be used even for large mandibular defects contrary to perceptions of many reconstructive surgeons.