Role of "revascularization surgery" in the management of mandibular osteoradionecrotic lesions: a report of twenty-one years of experience.

Experiment based on the conviction of a biological dimension of reconstructive surgery where the contribution of a vascularized transplant within irradiated tissue constitutes a physiological response to hypoxia, hypocellularity and hypovascularization characteristic of osteoradionecrotic injury. Between 1992 and 2013, 119 osteoradionecrotic lesions were treated requiring 125 free flaps. Revascularization surgery efficiency rate during the study period of 94%. Complex surgery: 49% complications including 38% vascular complications (total or partial flap necrosis) and 37% intolerance to osteosynthesis material. Proposal of a therapeutic algorithm retaining the indication of a revascularization surgery in case of cutaneous osteoradionecrotic damage and/or bone exposure greater than 2 centimeters and/or osteolysis of interest to the lower alveolar canal. This article is protected by copyright. All rights reserved.