[Evaluation of the use of free flaps of the anterior iliac crest. Review of 49 cases].

Because of the septic environment, the reconstruction of extensive losses of substance of the mandible has always raised numerous problems, especially as in a certain number of cases, concomitant radiotherapy represents an additional difficulty. Free flaps offer an important contribution. Up until now, we have essentially used the anterior iliac crest flap vascularised by the deep iliac circumflex pedicle. After 55 flaps of this type, the authors present an analysis of their results and try to analyse the causes for the failures. On the basis of their experience, they consider: that it is preferable to perform the bone and soft tissue repair by means of two different procedures (or at least by means of two different pedicles); that it is preferable, as far as possible, to perform immediate reconstructions rather than deferred reconstructions, especially in the case of malignant tumours.