Anionic Coordination Control in Building Cu-Based Electrocatalytic Materials for CO2 Reduction Reaction.

Renewable energy-driven conversion of CO2 to value-added fuels and chemicals via electrochemical CO2 reduction reaction (CO2RR) technology is regarded as a promising strategy with substantial environmental and economic benefits to achieve carbon neutrality. Because of its sluggish kinetics and complex reaction paths, developing robust catalytic materials with exceptional selectivity to the targeted products is one of the core issues, especially for extensively concerned Cu-based materials. Manipulating Cu species by anionic coordination is identified as an effective way to improve electrocatalytic performance, in terms of modulating active sites and regulating structural reconstruction. This review elaborates on recent discoveries and progress of Cu-based CO2RR catalytic materials enhanced by anionic coordination control, regarding reaction paths, functional mechanisms, and roles of different non-metallic anions in catalysis. Finally, the review concludes with some personal insights and provides challenges and perspectives on the utilization of this strategy to build desirable electrocatalysts.

Tuning Octahedral Tilting by Doping to Prevent Detrimental Phase Transition and Extend Carrier Lifetime in Organometallic Perovskites.

As one of the most promising materials for next-generation solar cells, organometallic perovskites have attracted substantial fundamental and applied interest. Using first-principles quantum dynamics calculations, we show that octahedral tilting plays an important role in stabilizing perovskite structures and extending carrier lifetimes. Doping the material with (K, Rb, Cs) ions at the A-site enhances octahedral tilting and the stability of the system relative to unfavorable phases. The stability of doped perovskites is maximized for uniform distribution of the dopants. Conversely, aggregation of dopants in the system inhibits octahedral tilting and the associated stabilization. The simulations also indicate that with enhanced octahedral tilting, the fundamental band gap increases, the coherence time and nonadiabatic coupling decrease, and the carrier lifetimes are thus extended. Our theoretical work uncovers and quantifies the heteroatom-doping stabilization mechanisms, opening up new avenues to enhancing the optical performance of organometallic perovskites.

Embedded Mo/Mn Atomic Regulation for Durable Acidity-Reinforced HZSM-5 Catalyst toward Energy-Efficient Amine Regeneration.

Metal-molecular sieve composites with high acidity are promising solid acid catalysts (SACs) for accelerating sluggish CO2 desorption processes and reducing the energy consumption of CO2 chemisorption systems. However, the production of such SACs through conventional approaches such as loading or ion-exchange methods often leads to uncontrolled and unstable metal distribution on the catalysts, which limits their pore structure regulation and catalytic performance. In this study, we demonstrated a feasible strategy for improving the durability, surface chemical activity, and pore structure of metal-doped HZSM-5 through bimetallic Mo/Mn modification. This strategy involves the immobilization of Mo-O-Mn species confined in an MFI structure by regulating MoO42- anions and Mn2+ cations. The embedded Mn/Mo species of low valence can strongly induce electron transfer and increase the density of compensatory H+ on the MoMn@H catalyst, thereby reducing the CO2 desorption temperature by 8.27 °C and energy consumption by 37% in comparison to a blank. The durability enhancement and activity regulation method used in this study is expected to advance the rational synthesis of metal-molecular sieve composites for energy-efficient CO2 capture using amine regeneration technology.

In Situ Reconstruction of Active Catalysis Sites Triggered by Chromium Immobilization for Sulfite Oxidation.

Hexavalent chromium (Cr(VI)) is a highly toxic substance in wastewater, triggering grievous detriment to aquatic life and human health. Magnesium sulfite is spawned along with the desulfurization process in coal-fired power plants, which is usually disposed of as solid waste. Here, a "waste control by waste" method was proposed upon the redox of Cr(VI)-sulfite, in which highly toxic Cr(VI) is detoxicated and sequent enriched on a novel biochar-induced cobalt-based silica composite (BISC) due to the forced electron transfer from chromium to surface hydroxyl. The immobilized Cr on BISC gave rise to the reconstruction of catalytic active sites "Cr-O-Co", which further enhance its performance in sulfite oxidation by elevating O2 adsorption. As a result, the sulfite oxidation rate increased by 10 times compared with the non-catalysis benchmark together with the maximum chromium adsorption capacity being 120.3 mg/g. Therefore, this study provides a promising strategy to simultaneously control highly toxic Cr(VI) and sulfite, achieving high-grade sulfur resource recovery for wet magnesia desulfurization.

Comparison of outcomes between single- and multiple-perforator-based free perforator flaps: A systematic review and meta-analysis.

BACKGROUND: Perforator-based free perforator flaps have become an important tool for the reconstruction of tissue defects. The effect of the number of perforators on the outcomes of perforator flaps has been widely debated. This study aimed to compare the outcomes of single- and multiple-perforator-based free perforator flaps in free-flap reconstruction. METHODS: We searched PubMed, Web of Science, EMBASE, Chinese BioMedical Literature Database (CBM), Cochrane Library, and clinicaltrials.gov between January 2000 and June 2021 to identify studies that reported data on the outcomes of free perforator flaps. Two authors individually extracted data and performed quality assessment. Outcomes, including partial flap loss, total loss, fat necrosis, arterial insufficiency, venous insufficiency, hemorrhage and hematoma, wound dehiscence at recipient sites and donor site complications, were evaluated. RESULTS: Thirty-two studies with 2498 flaps were included in our analysis. No significant difference was found in the rates of partial loss and arterial insufficiency of flaps, hemorrhage and hematoma, wound dehiscence at recipient sites and donor site complications. However, the multiple-perforator group showed significantly lower rates of total loss (relative risk [RR] = 1.08, 95% confidence interval [CI]: 0.78-1.79, p = .754), fat necrosis (RR = 1.79, 95% [CI]: 1.36-2.36, p = .000) and venous insufficiency (RR = 1.72, 95% CI: 1.07-2.79, p = .026) than the single-perforator group. CONCLUSION: The rates of total loss, fat necrosis and venous insufficiency in the multiple-perforator group were lower than those in the single-perforator group. Hence, we recommend that multiple perforators be included in the free perforator flap when appropriate, to yield better clinical outcomes in reconstruction.

Superconductivity in Layered van der Waals Hydrogenated Germanene at High Pressure.

The emergence of superconductivity in two-dimensional (2D) materials has attracted tremendous research efforts because the origins and mechanisms behind the unexpected and fascinating superconducting phenomena remain unclear. In particular, the superconductivity can survive in 2D systems even with weakened disorder and broken spatial inversion symmetry. Here, structural and superconducting transitions of 2D van der Waals (vdW) hydrogenated germanene (GeH) are observed under compression and decompression processes. GeH possesses a superconducting transition with a critical temperature (Tc) of 5.41 K at 8.39 GPa. A crystalline to amorphous transition occurs at 16.80 GPa, while superconductivity remains. An abnormal increase of Tc up to 6.11 K was observed during the decompression process, while the GeH remained in the 2D amorphous phase. A combination study of in situ high-pressure synchrotron X-ray diffraction, in situ high-pressure Raman spectroscopy, transition electron microscopy, and density functional theory simulations suggests that the superconductivity in 2D vdW GeH is attributed to the increased density of states at the Fermi level as well as the enhanced electron-phonon coupling effect under high pressure even in the form of an amorphous phase. The unique pressure-induced phase transition of GeH from 2D crystalline to 2D amorphous metal hydride provides a promising platform to study the mechanisms of amorphous hydride superconductivity.

Atomic Replacement of PtNi Nanoalloys within Zn-ZIF-8 for the Fabrication of a Multisite CO2 Reduction Electrocatalyst.

Exploring the transformation/interconversion pathways of catalytic active metal species (single atoms, clusters, nanoparticles) on a support is crucial for the fabrication of high-efficiency catalysts, the investigation of how catalysts are deactivated, and the regeneration of spent catalysts. Sintering and redispersion represent the two main transformation modes for metal active components in heterogeneous catalysts. Herein, we established a novel solid-state atomic replacement transformation for metal catalysts, through which metal atoms exchanged between single atoms and nanoalloys to form a new set of nanoalloys and single atoms. Specifically, we found that the Ni of the PtNi nanoalloy and the Zn of the ZIF-8-derived Zn1 on nitrogen-doped carbon (Zn1-CN) experienced metal interchange to produce PtZn nanocrystals and Ni single atoms (Ni1-CN) at high temperature. The elemental migration and chemical bond evolution during the atomic replacement displayed a Ni and Zn mutual migration feature. Density functional theory calculations revealed that the atomic replacement was realized by endothermically stretching Zn from the CN support into the nanoalloy and exothermically trapping Ni with defects on the CN support. Owing to the synergistic effect of the PtZn nanocrystal and Ni1-CN, the obtained (PtZn)n/Ni1-CN multisite catalyst showed a lower energy barrier of CO2 protonation and CO desorption than that of the reference catalysts in the CO2 reduction reaction (CO2RR), resulting in a much enhanced CO2RR catalytic performance. This unique atomic replacement transformation was also applicable to other metal alloys such as PtPd.

Ru-Co Pair Sites Catalyst Boosts the Energetics for the Oxygen Evolution Reaction.

Manipulating the coordination environment of the active center via anion modulation to reveal tailored activity and selectivity has been widely achieved, especially for carbon-based single-atom site catalysts (SACs). However, tuning ligand fields of the active center by single-site metal cation regulation and identifying the effects on the resulting electronic configuration is seldom explored. Herein, we propose a single-site Ru cation coordination strategy to engineer the electronic properties by constructing a Ru/LiCoO2 SAC with atomically dispersed Ru-Co pair sites. Benefitting from the strong electronic coupling between Ru and Co sites, the catalyst possesses an enhanced electrical conductivity and achieves near-optimal oxygen adsorption energies. Therefore, the optimized catalyst delivers superior oxygen evolution reaction (OER) activity with low overpotential, the high mass activity of 1000 A goxide -1 at a small overpotential of 335 mV, and excellent long-term stability. It also exhibits rapid kinetics with superior rate capability and outstanding durability in a zinc-air battery.

Atomic Structural Evolution of Single-Layer Pt Clusters as Efficient Electrocatalysts.

The rational synthesis of single-layer noble metal directly anchored on support materials is an elusive target to accomplish for a long time. This paper reports well-defined single-layer Pt (Pt-SL) clusters anchored on ultrathin TiO2 nanosheets-as a new frontier in electrocatalysis. The structural evolution of Pt-SL/TiO2 via self-assembly of single Pt atoms (Pt-SA) is systematically recorded. Significantly, the Pt atoms of Pt-SL/TiO2 possess a unique electronic configuration with PtPt covalent bonds surrounded by abundant unpaired electrons. This Pt-SL/TiO2 catalyst presents enhanced electrochemical performance toward diverse electrocatalytic reactions (such as the hydrogen evolution reaction and the oxygen reduction reaction) compared with Pt-SA, multilayer Pt nanoclusters, and Pt nanoparticles, suggesting an efficient new type of catalyst that can be achieved by constructing single-layer atomic clusters on supports.

The Effect of Medial Sural Artery Perforator Flap on Reconstruction of Soft Tissue Defects: A Meta-Analysis With Multiple Free Soft Flaps.

BACKGROUND: With the gradual popularity of relatively novel medial sural artery perforator flap (MSAPF), robust studies are needed to compare the surgical outcomes of MSAPF versus multiple free soft flaps (MFSFs) to verify the advantages and disadvantages of MSAPF. METHODS: The authors searched PubMed, Web of Science, EMBASE, Cochrane Library, Chinese BioMedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) until September, 2020, to identify studies that compared surgical outcomes of MSAPF and MFSFs. Two authors followed the PRISMA guidelines, individually extracted the data and performed the quality assessments. Survival rate of flaps, satisfaction degree of patients in recipient and donor site, skin grafting, and morbidity of recipient and donor site were evaluated. RESULTS: A total of 441 cases from 7 studies were included in our analysis. No significant differences were found regarding survival rate of flaps, recipient morbidity, and recipient satisfaction degree between the 2 groups. However, MSAPF group was significantly superior to MFSFs group in terms of skin grafting, morbidity, and satisfaction degree of donor site. CONCLUSION: Our meta-analysis showed that the MSPAF and MFSFs groups were similar in terms of survival rate of flaps, recipient morbidity, and recipient satisfaction degree. Medial sural artery perforator flap group was superior to MFSFs group in terms of morbidity and satisfaction degree of donor site. The results may prove that MSAPF is gaining popularity for a reason and is a good choice for repairing soft tissue defects.

High-performance natural-sunlight-driven Ag/AgCl photocatalysts with a cube-like morphology and blunt edges via a bola-type surfactant-assisted synthesis.

Ag/AgCl-based structures have recently been receiving considerable attention as visible-light-driven plasmonic photocatalysts, wherein the fabrication of Ag/AgCl species shaped with an anisotropic morphology is considered to be an efficient way to enhance their performances. While the past decade has witnessed great progress in this direction, it is still strongly desired to initiate a green and low-cost protocol for the synthesis of Ag/AgCl based structures with high catalytic activity. Using a surfactant-assisted synthesis protocol, wherein a cationic bola-type surfactant of chloride counteranions serves both as a reactant (namely, source of chlorine) for the generation of AgCl structures and as a directing template to assist the formation of anisotropic structures, we herein report that cube-like Ag/AgCl with blunt edges could be fabricated simply by dropping an aqueous solution of silver nitrate into an ethanol solution of the hexane-1,6-bis(trimethylammonium chloride) surfactant. Importantly, compared to the sphere-like counterparts manufactured using a conventional tadpole surfactant, the as-fabricated cube-like structures exhibit substantially improved catalytic performances under visible-light or natural-sunlight irradiation. It has been revealed that photogenerated holes might serve as the main active species during the catalytic process. Meanwhile, our results have disclosed that in contrast to the sphere-like Ag/AgCl structures, the as-constructed cube-like structures are relatively enriched with high-index AgCl facets of smaller hole effective mass, which promote a faster carrier transfer, facilitate the migration of the photogenerated holes to the surface to be involved in photocatalytic reactions, and suppress carrier recombination, leading to their enhanced photocatalytic performances. Considering the tremendous diversity of surfactants (bola-, gemini-, polymeric surfactants etc.) with various halide counteranions and their sophisticated template effects, our new strategy might open up new opportunities for silver/silver halide (Ag/AgX, X = Cl, Br, and I)-based plasmonic structures with various morphologies and with superior light-to-chemical energy conversion capability.

Comparison of Internal Jugular Vein System Anastomosis and External Jugular Vein System Anastomosis in Free Flaps for Head and Neck Reconstruction: A Meta-Analysis.

PURPOSE: The purpose of the present study was to investigate the differences in postoperative thrombosis and flap failure between internal jugular vein (IJV) system anastomosis and external jugular vein (EJV) system anastomosis in free flaps for the reconstruction of head and neck defects. MATERIALS AND METHODS: We searched PubMed, Web of Science, EMBASE, Chinese BioMedical Literature Database, and other databases until March 2019 for studies that had reported data for anastomosis for the 2 different venous systems in the microvascular free-flap reconstruction of head and neck defects. We assessed thrombosis and flap failure in patients undergoing anastomosis of the IJV system and patients undergoing anastomosis of the EJV system. RESULTS: Nine studies with a total of 2051 patients with venous anastomosis were included in the present meta-analysis. IJV system anastomosis showed a significantly lower incidence of venous thrombosis than did the EJV system (relative risk [RR], 0.55; 95% confidence interval [CI], 0.37 to 0.82). Eight studies were included in the analysis of the flap failure rate, which showed a lower failure rate for the IJV system anastomosis than for the EJV system (RR, 0.59; 95% CI, 0.35 to 1.00). CONCLUSIONS: The incidence of thrombosis and flap failure after venous anastomosis in the IJV system was lower than that in the EJV system. The results from the present study have shown that the IJV system should be the first choice for venous anastomosis in the reconstruction of free flaps.

Solar-Driven Nitrogen Fixation Catalyzed by Stable Radical-Containing MOFs: Improved Efficiency Induced by a Structural Transformation.

Herein we present a new viologen-based radical-containing metal-organic framework (RMOF) Gd-IHEP-7, which upon heating in air undergoes a single-crystal-to-single-crystal transformation to generate Gd-IHEP-8. Both RMOFs exhibit excellent air and water stability as a result of favorable radical-radical interactions, and their long-lifetime radicals result in wide spectral absorption in the range 200-2500 nm. Gd-IHEP-7 and Gd-IHEP-8 show excellent activity toward solar-driven nitrogen fixation, with ammonia production rates of 128 and 220 µmol h-1 g-1 , respectively. Experiments and theoretical calculations indicate that both RMOFs have similar nitrogen fixation pathways. The enhanced catalytic efficiency of Gd-IHEP-8 versus Gd-IHEP-7 is attributed to intermediates stabilized by enhanced hydrogen bonding.

Quality of Life After Oral Cancer Resection and Free Flap Reconstruction.

PURPOSE: This study focused on quality of life for patients in northeast China who underwent oral cancer resection directly before flap reconstruction. In addition, this study compared differences among the radial forearm free flap (RFFF), ulnar forearm free flap (UFFF), and anterolateral thigh flap (ALTF) for defect reconstruction. MATERIALS AND METHODS: To assess patients' quality of life, the University of Washington Quality of Life and 14-item Oral Health Impact Profile (OHIP-14) questionnaires were completed 6 months after reconstruction. RESULTS: The flap size of the ALTF group was much larger than that of the UFFF and RFFF groups. The appearance score of the ALTF group was markedly higher than that of the UFFF and RFFF groups, whereas these groups had a much higher swallowing score than the ALTF group. Furthermore, the ALTF group had much lower social disability OHIP-14 scores than the RFFF group. CONCLUSIONS: The results indicate that all 3 reconstruction methods are similar, but that the ALTF has a slight advantage over the UFFF and RFFF.

Miniplates Versus Reconstruction Plates in Vascularized Osteocutaneous Flap Reconstruction of the Mandible.

PURPOSE: The main aim of this article is to compare the complication rate associated with the use of miniplates versus reconstruction plates in vascularized osteocutaneous flap reconstruction of the mandible. PATIENTS AND METHODS: The authors searched PubMed, Web of Science, EMBASE, Chinese BioMedical Literature Database (CBM), Cochrane Library, and clinicaltrials.gov up to September 2017 to identify studies that compared the complication rate of miniplates versus reconstruction plates in patients undergoing mandibular reconstruction. Two reviewers individually extracted the data and performed a quality assessment. Plate exposure, plate fracture/removal, infection, and overall complications were evaluated. RESULTS: Five studies with 511 cases were included in our analysis. No significant difference was found between the groups. However, the reconstruction plate led to fewer overall complications and plate exposure postoperatively than did the miniplate. CONCLUSION: Our meta-analysis suggests that miniplates and reconstruction plates are suitable for mandibular reconstruction with a vascularized osteocutaneous flap.

Direct Observation of Oxygen Vacancy Self-Healing on TiO2 Photocatalysts for Solar Water Splitting.

Oxygen vacancy (Vo) on transition metal oxides plays a crucial role in determining their chemical/physical properties. Conversely, the capability to directly detect the changing process of oxygen vacancies (Vos) will be important to realize their full potentials in the related fields. Herein, with a novel synchronous illumination X-ray photoelectron spectroscopy (SI-XPS) technique, we found that the surface Vos (surf-Vos) exhibit a strong selectivity for binding with the water molecules, and sequentially capture an oxygen atom to achieve the anisotropic self-healing of surface lattice oxygen. After this self-healing process, the survived subsurface Vos (sub-Vos) promote the charge excitation from Ti to O atoms due to the enriched electron located on low-coordinated Ti sites. However, the excessive sub-Vos would block the charge separation and transfer to TiO2 surfaces resulted from the destroyed atomic structures. These findings open a new pathway to explore the dynamic changes of Vos and their roles on catalytic properties, not only in metal oxides, but in crystalline materials more generally.

Reconstruction of a subtotal upper lip defect with a facial artery musculomucosal flap, kite flap, and radial forearm free flap: a case report.

BACKGROUND: For reconstructive surgeons, massive midface defects, including large, full-thickness wounds on the upper lip, can be very challenging. Although there are many methods for reconstruction of upper lip defects, it is difficult to obtain satisfactory restoration of oral functions and good cosmetic results. CASE PRESENTATION: This case report presents a man with massive midface defects, including upper lip, left nose, and cheek defects. Over the previous 2 years, the patient had three reconstructions with sequential free flaps for the resection of recurrent tumors, the first of which was in March of 2016; this resulted in the patient having massive midface defects, including an upper lip defect, a defect on the left side of the nose, and one on the left cheek. The defects were reconstructed using a radial forearm free flap (RFFF), a facial artery musculomucosal (FAMM) flap, and a kite flap. In June 2016, he underwent a second reconstruction, this time of the left nose defect, using a left anterolateral thigh (ALT) flap. In March of 2017, the patient underwent a third reconstruction with the use of a free ALT on the left intraoral cheek and the defects on the neck. All flaps survived. No complications were encountered postoperatively. The patient regained good oral sphincter function with no reports of drooling. Although the patient underwent three surgeries, the reconstruction results were acceptable. CONCLUSIONS: For massive midface defects, including large, full-thickness wounds on the upper lip, the combination of a FAMM flap, kite flap, and RFFF promotes the reconstruction of the complex midface structure and improves the resulting functionality.

The application of fibular free flap with flexor hallucis longus in maxilla or mandible extensive defect: a comparison study with conventional flap.

BACKGROUND: The repair and reconstruction of maxillary and mandibular extensive defects have put huge challenges to surgeons. The fibular free flap (FFF) is one of the standard treatment choices for reconstruction. The conventional FFF has deficiencies, such as forming poor oral mucosa, limited flap tissue, and perforator vessel variation. To improve the use of FFF, we add the flexor hallucis longus (FHL) in the flap (FHL-FFF). In this paper, we described the advantage and indication of FHL-FFF and conducted a retrospective study to compare FHL-FFF and FFF without FHL. METHODS: Fifty-four patients who underwent FFF were enrolled and divided into two groups: nFHL group (using FFF without FHL, 38 patients) and FHL group (using FHL-FFF, 16 patients). The perioperative clinical data of patients was collected and analyzed. RESULTS: The flaps all survived in two groups. We mainly used FHL to fill dead space, and the donor-site morbidity was slight. In FHL group, flap harvesting time was shorter (118.63 ± 11.76 vs 125.74 ± 11.33 min, P = 0.042), the size of flap's skin paddle was smaller (16.5 (0-96) vs 21.0(10-104) cm2, P = 0.027) than nFHL group. There were no significant differences (P > 0.05) in hospital days, hospitalization expense, rate of perioperative complications, etc. between the two groups. Compared with FFF without FHL, FHL-FFF will neither affect the use of flap nor bring more problems. CONCLUSION: The FHL-FFF simplifies the flap harvesting operation. The FHL can form good mucosa and make FFF rely less on skin paddle. It can be used for adding flap tissue and dealing with perforator vessel variation in reconstruction of maxillary and mandibular extensive defects.

Elderly population have a decreased aneurysmal subarachnoid hemorrhage incidence rate than Middle aged population: a descriptive analysis of 8,144 cases in mainland China.

PURPOSE: Rupture of an intracranial aneurysm is a life-threatening acute cerebrovascular event. The purpose of this study was to investigate whether aneurysmal subarachnoid haemorrhage (SAH) incidence rate is higher or lower in elderly population than in middle aged population. MATERIALS AND METHODS: Aneurysmal SAH cases were collected retrospectively from the archives of 21 hospitals in Mainland China. All the cases were collected from September 2016 and backward consecutively for a period of time up to 8 years. SAH was initially diagnosed by brain computed tomography (CT). CT angiography (CTA) or digital subtraction angiography (DSA) was followed and SAH was confirmed to be due to cerebral aneurysm rupture. For cases when multiple bleeding occurred, the age of the first SAH was used in this study. The total incidence from all hospitals at each age group were summed together for females and males respectively; then adjusted by the total population number at each age group for females and males which was from the 2010 population census of the People's Republic of China. RESULTS: In total there were 8,144 cases of intracranial aneurysmal SAH, with 4,861 females and 3,283 males. For females the relative aneurysmal SAH incidence rate started to decrease after around 65 years old, while for males the relative aneurysmal SAH incidence rate started to decrease after around 53 years old. CONCLUSION: Our data tentatively suggest elderly patients may be at a reduced risk of rupture compared with patients who are younger while have similar other risk factors.

Reconstruction of Complex Total Parotidectomy Defect With a Chimeric Anterolateral Thigh Perforator Flap and Vascularized Motor Branch of Femoral Nerve Grafting.

Reconstruction of complex total parotidectomy defects after ablation is always a challenge for surgeons. The surgical technique in reconstructing total parotidectomy defects using an anterolateral thigh (ALT) flap has not been described in detail. This report describes the treatment of a difficult case with a complex total parotidectomy defect. An ALT flap composed of a vascularized motor branch of the femoral nerve and a narrow portion of the vastus lateralis muscle was harvested. An 8-cm-long vascularized nerve was transplanted into the gap, which can be considered a cable transplant graft, and a myocutaneous paddle was used to cover and fill in the soft tissue defect. There were no complications after surgery, and the patient was satisfied with the reconstructed facial contours. This case shows that using a chimeric ALT flap for reconstruction is possible in a complex total parotidectomy defect.