Prefabrication is a method of preliminary flap preparation that involves creating new biological properties in the component tissues, allowing them to be used, for specific indications, in oncological patients to replace extensive combined soft tissue and bone defects of the maxillofacial region. Surgery using prefabrication involves a two‑stage treatment of patients, which helps reduce the risk of postoperative complications and the overall severity of the interventions.

During a systematic review of retrospective studies and a computerised search in MEDLINE using the PubMed service (www.pubmed.org) and the Scopus database (www.scopus.com), it was found that the term “prefabrication” is used by authors in various contexts, and that the use of rib prefabrication as part of a TDL to replace extensive soft tissue and bone defects of the maxillofacial region had not been performed previously and is innovative.

The prefabrication technique was successfully tested in an experimental study on laboratory animals. Based on the results obtained, a group of 25 patients who underwent secondary, repeated surgeries using rib prefabrication as part of a TDL was included in clinical practice. The transfer of the plastic material was performed on a vascular pedicle in 23 patients; in 2 patients, free transplantation using microsurgical technique was carried out. No complications were noted.

Follow‑up observations of all patients operated on using the rib prefabrication technique as part of a TDL showed complete engraftment of both the bone and soft tissue components of the flap. The flap was always transferred to the recipient area on a vascular pedicle. This indicates that the described technique is more effective and reliable compared to traditional or microsurgical methods, in which complications leading to loss of the bone part of the flap were observed in more than 50% of patients. Patients with comorbidities always tolerate the two‑stage surgical treatment method more easily.

Anton Alekseevich Orlov is a maxillofacial surgeon and dental implantologist from Saint Petersburg. He is supervised by Nikolai Viktorovich Kalakutsky, Professor of Medicine, Doctor of Medical Sciences.