Tiftikcioglu, Yigit OzerGur, ErsinGurler, Tahir2019-10-272019-10-2720171049-22751536-3732https://doi.org/10.1097/SCS.0000000000003342https://hdl.handle.net/11454/32356Background: The fibula flap is a workhorse flap for bony reconstruction of oro-mandibular area and can be modified to include soft tissue for reconstruction of composite defects. However, the design of a reliable skin paddle that can be used for composite tissue reconstruction remains a challenge. The authors described the applicability of perforator concept for a more reliable free osteo-musculocutaneous fibula flap. Methods: Between 2013 and 2015, 29 patients underwent free fibula osteocutaneous flap reconstruction. Twenty-two patients have been operated due to squamous cell carcinoma and 7 patients due to gunshot injuries. Results: The mean harvesting time was 60 +/- 15 minutes. The range of width of the skin paddle was 3 to 12 cm and length was 6 to 23 cm. The range of length of bone was 5 to 18 cm. One patient had revision due to venous occlusion. All flaps have survived. Conclusion: The authors advocate approaching all components of flap individually using the perforator concept and dissection. Good exposure is mandatory for a reliable dissection. In our opinion, the posterior approach is more useful as it reveals all vascular relationships between the bone, muscle, skin paddle, and peronel vessels.en10.1097/SCS.0000000000003342info:eu-repo/semantics/closedAccessFree fibula flapmandible reconstructionperforator flapArticle282559563WOS:00039604220009628045826Q2Q4