Postoperative functional training program for vascularised Iliac flap donor site in jaw defect reconstruction based on the Delphi method
Abstract Vascularised iliac flaps (VIFs) are widely used for the reconstruction of jawbone defects; however, postoperative donor-site complications, such as gait disturbances, with an incidence of 13.9–50%, significantly impede patient recovery. Despite this, evidence-based rehabilitation protocols...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-08-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-025-13774-x |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849343481426739200 |
|---|---|
| author | Li Li Qian He Na Zhou Zhaoxia Zhang Xiaoming Lv Jie Zhang |
| author_facet | Li Li Qian He Na Zhou Zhaoxia Zhang Xiaoming Lv Jie Zhang |
| author_sort | Li Li |
| collection | DOAJ |
| description | Abstract Vascularised iliac flaps (VIFs) are widely used for the reconstruction of jawbone defects; however, postoperative donor-site complications, such as gait disturbances, with an incidence of 13.9–50%, significantly impede patient recovery. Despite this, evidence-based rehabilitation protocols specific to VIFs remain lacking. Existing rehabilitation guidelines for hip surgeries are unsuitable owing to differences in surgical mechanisms. This study employed the Delphi method, engaging 20 multidisciplinary experts (oral and maxillofacial surgery: 5; orthopaedics: 7; rehabilitation: 6; nursing: 2). Through three rounds of anonymous consultations, and by integrating literature evidence with postoperative mobility assessments, we developed a phased, individualised progressive functional training (PFT) protocol featuring dynamic evaluation, coordinated activation of abdominal and hip muscle groups, and safe exercise strategies during head and neck immobilisation, while overcoming conventional hip rehabilitation limitations (e.g., restrictions on flexion < 90°, and bans on squatting or cross-legged sitting). PFT is structured into six progressive phases, with exercise intensity tailored to assessment outcomes. A single-centre randomised controlled trial (n = 62) demonstrated that PFT significantly accelerated lower limb functional recovery, improved hip mobility and balance, reduced donor-site pain, and enhanced quality of life (University of Washington Quality of Life questionnaire: F (1,60) = 17.262, P < 0.001), without increasing the risk of flap vascular compromise or iliac hematoma. The limitations of the study include the single-centre design and lack of cross-cultural validation. Future multicentre studies are required to enhance adaptability. This study establishes a foundational yet effective framework for post-VIF rehabilitation, guiding clinical practice and research advancements. |
| format | Article |
| id | doaj-art-ce0a4d5ad3ab43c881a9aba3b92e37e5 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-ce0a4d5ad3ab43c881a9aba3b92e37e52025-08-20T03:42:57ZengNature PortfolioScientific Reports2045-23222025-08-011511910.1038/s41598-025-13774-xPostoperative functional training program for vascularised Iliac flap donor site in jaw defect reconstruction based on the Delphi methodLi Li0Qian He1Na Zhou2Zhaoxia Zhang3Xiaoming Lv4Jie Zhang5Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical DevicesDepartment of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical DevicesDepartment of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical DevicesDepartment of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical DevicesDepartment of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical DevicesDepartment of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical DevicesAbstract Vascularised iliac flaps (VIFs) are widely used for the reconstruction of jawbone defects; however, postoperative donor-site complications, such as gait disturbances, with an incidence of 13.9–50%, significantly impede patient recovery. Despite this, evidence-based rehabilitation protocols specific to VIFs remain lacking. Existing rehabilitation guidelines for hip surgeries are unsuitable owing to differences in surgical mechanisms. This study employed the Delphi method, engaging 20 multidisciplinary experts (oral and maxillofacial surgery: 5; orthopaedics: 7; rehabilitation: 6; nursing: 2). Through three rounds of anonymous consultations, and by integrating literature evidence with postoperative mobility assessments, we developed a phased, individualised progressive functional training (PFT) protocol featuring dynamic evaluation, coordinated activation of abdominal and hip muscle groups, and safe exercise strategies during head and neck immobilisation, while overcoming conventional hip rehabilitation limitations (e.g., restrictions on flexion < 90°, and bans on squatting or cross-legged sitting). PFT is structured into six progressive phases, with exercise intensity tailored to assessment outcomes. A single-centre randomised controlled trial (n = 62) demonstrated that PFT significantly accelerated lower limb functional recovery, improved hip mobility and balance, reduced donor-site pain, and enhanced quality of life (University of Washington Quality of Life questionnaire: F (1,60) = 17.262, P < 0.001), without increasing the risk of flap vascular compromise or iliac hematoma. The limitations of the study include the single-centre design and lack of cross-cultural validation. Future multicentre studies are required to enhance adaptability. This study establishes a foundational yet effective framework for post-VIF rehabilitation, guiding clinical practice and research advancements.https://doi.org/10.1038/s41598-025-13774-xVascularised iliac flapDelphi methodFunctional trainingNursing |
| spellingShingle | Li Li Qian He Na Zhou Zhaoxia Zhang Xiaoming Lv Jie Zhang Postoperative functional training program for vascularised Iliac flap donor site in jaw defect reconstruction based on the Delphi method Scientific Reports Vascularised iliac flap Delphi method Functional training Nursing |
| title | Postoperative functional training program for vascularised Iliac flap donor site in jaw defect reconstruction based on the Delphi method |
| title_full | Postoperative functional training program for vascularised Iliac flap donor site in jaw defect reconstruction based on the Delphi method |
| title_fullStr | Postoperative functional training program for vascularised Iliac flap donor site in jaw defect reconstruction based on the Delphi method |
| title_full_unstemmed | Postoperative functional training program for vascularised Iliac flap donor site in jaw defect reconstruction based on the Delphi method |
| title_short | Postoperative functional training program for vascularised Iliac flap donor site in jaw defect reconstruction based on the Delphi method |
| title_sort | postoperative functional training program for vascularised iliac flap donor site in jaw defect reconstruction based on the delphi method |
| topic | Vascularised iliac flap Delphi method Functional training Nursing |
| url | https://doi.org/10.1038/s41598-025-13774-x |
| work_keys_str_mv | AT lili postoperativefunctionaltrainingprogramforvascularisediliacflapdonorsiteinjawdefectreconstructionbasedonthedelphimethod AT qianhe postoperativefunctionaltrainingprogramforvascularisediliacflapdonorsiteinjawdefectreconstructionbasedonthedelphimethod AT nazhou postoperativefunctionaltrainingprogramforvascularisediliacflapdonorsiteinjawdefectreconstructionbasedonthedelphimethod AT zhaoxiazhang postoperativefunctionaltrainingprogramforvascularisediliacflapdonorsiteinjawdefectreconstructionbasedonthedelphimethod AT xiaominglv postoperativefunctionaltrainingprogramforvascularisediliacflapdonorsiteinjawdefectreconstructionbasedonthedelphimethod AT jiezhang postoperativefunctionaltrainingprogramforvascularisediliacflapdonorsiteinjawdefectreconstructionbasedonthedelphimethod |