One-stage reconstruction of tracheal defects with the medial femoral condyle corticoperiosteal-cutaneous free flap

Background. The demanding anatomic and mechanical requirements make the reconstruction of long tracheal defects challenging. Multiple attempts at replacing tracheal segments are described, including the use of autologous, allogeneic, and synthetic tissues. However, the multilayer structure of the trachea and its function as a conduit for air had generally resulted in the use of nonvascularized tissue and/or multistage procedures. Methods. The authors report on a 1-stage autologous reconstruction using local skin flaps for inner lining and a free medial femoral condyle corticoperiosteal-cutaneous (FCCPC) flap for the remaining layers. The skin island directly located over the FCCPC flap serves as an external coverage of the tracheal reconstruction. Results. Within the follow-up, the reconstructed trachea has retained its shape, diameter, and airway function. No notable stenosis or instability was observed. Conclusion. This concept combines ideal biological and mechanical tissue properties, offering the potential to meet the reconstructive requirements for extended tracheal defects. (C) 2016 Wiley Periodicals, Inc.