Abstract: PURPOSE： To explore the microscopic features and effect of severe traumatic oro-maxillofacial defects with free vascularized flaps. METHODS: A retrospective analysis was performed in 11 consecutive cases with severe traumatic oro-maxillofacial defects from 2005 to 2018, all patients had compound tissue defects, which involved multiple anatomical regions(for example: lip, cheek, nose, ears, tempus, jaws, etc). Meanwhile,long-standing traumatic patients had severe scars and tissue displacement. All cases were reconstructed with free vascularized flaps by using microvascular surgical technique, which included 4 forearm flaps, there fibular osteocutaneous flaps, one lateral thoracic flap,and 3 anterolateral thigh flaps. RESULTS: Eleven patients were treated effectively, and followed-up for 1 year to 13 years, the survival rate of the free vascularized tissue flaps was 100%. No complications occurred such as flap crisis, and 10 patients were satisfied with their postoperative shape and function. CONCLUSIONS: Oro-maxillofacial traumatic defects display unique features, and microsurgical techniques play an important role in the reconstruction of shape and function, especially in large defects where local or adjacent flaps can not be used. Accurate assessment of the severity of injury and soft and hard tissue defects, and appropriate selection of free vascularized flaps are the keys to the application of this technique to achieve good results.

Key words: Traumatic defects, Microsurgical technique, Free vascularized flaps, Reconstruction