chapter  36
12 Pages

Surgical Principles of Deep Circumex Iliac Artery

The iliac crest ap has long been used for bony reconstruction of the mandible. Autologous cancellous bone from the ilium replaced prosthetic appliances in the 1890s as the reconstruction of choice for mandibular defects.19 During World War I, non-vascularised iliac crest bone was used and held in place with external xation. In World War II, internal xation was used and antibiotics were introduced.2 Although these techniques signicantly impacted on wound healing, results remained poor, with a high rate of failure. From the 1960s, a combination of metallic plates and non-vascularised bone graft were used, but these were also complicated by infection, exposure, and fracture.2,20 Regardless of whether the ilium, rib, or prosthetic material was used, it was nally recognised that non-vascularised bony grafts all tended to result in high rates of non-union, resorption, and

36.1 Introduction .......................................................................................................................... 597 36.2 History of the DCIA Flap ..................................................................................................... 597 36.3 Anatomy of the DCIA .......................................................................................................... 598 36.4 Imaging of the DCIA ............................................................................................................ 599 36.5 Clinical Application of DCIA Flap ......................................................................................602 36.6 Conclusion ............................................................................................................................604 References ......................................................................................................................................605