ABSTRACT
The vascularised iliac crest free flap is a highly versatile free flap for head and neck reconstruction. It provides the best bone stock for orofacial reconstruction, allowing adequate quality and quantity of bone for man dible or maxillary reconstruction and oral rehabili tation with dental implants. It can be raised as a bone-only flap but is commonly raised as a bone and muscle flap utilising the internal oblique muscle for soft tissue coverage. The blood supply is from the deep circumflex iliac artery (DCIA) (a branch of the external iliac artery) and its venae comitantes (which drain into the saphenous vein, then into the femoral vein). The flap can be used for reconstruction of segmental mandibular defects, particularly in dentate patients. Contraindications to using a DCIA include a previous iliac crest graft, an inguinal hernia repair or previous abdominal surgery within the surgical field.
