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The treatment of tissue defects related to the compartment syndrome occurring in the fibula osteocutaneous free flap donor area with vacuum assisted closure therapy

Today, fibula osteocutaneous flap is commonly used for the reconstruction of segmental mandible defect. Early and late donor site complications have been reported in the literature. The most serious early complication of flap donor sites is compartment syndrome. Compartment syndrome in the donor area may develop depending on the increase in the intracompartmental pressure as a result of the largeness of skin flap and the primary closure of the donor area. In this letter, we present a case of the compartment syndrome which is developed in osteocutaneous fibula flap donor area containing 4-cm wide skin area, and the treatment of related tissue defect with vacuum-assisted closure (VAC) therapy. A 58-year-old male patient applied to our clinic complaining of wounds in the jaw and mouth existing for 5 months. In physical examination, a 9 3 6 cm expansive mass was identified as fixed to mandible and invaded in the mouth. Bone destruction was observed in radiological examination. Routine laboratory examinations were in normal range. In surgical treatment, segmental mandibulectomy and unilateral neck dissection was performed. Fibula osteocutaneous flap was planned for oral cavity mucosa defect and segmental mandible reconstruction. On the posterior crural intermuscular septum, perforator artery was determined with Doppler ultrasound. Under the pneumatic tourniquet, with standard lateral approach 12 3 4 cm flap