Learning curve in mandibular reconstruction with vascularized iliac crest free flap: a cumulative sum analysis.

The repair of mandibular defects is challenging due to the functional and structural complexity of the mandible. The aim of this study was to evaluate the learning curve of mandibular reconstruction using a vascularized iliac crest free flap (ICFF) performed by a single surgeon. This retrospective study used the cumulative sum (CUSUM) method to analyse the operation times of 60 patients who underwent mandibular reconstruction surgery with an ICFF between 2013 and 2022. The results showed that the learning curve could be divided into two phases according to the turning point: phase 1 comprised cases 1-17 and phase 2 comprised cases 18-60. The operation time and length of hospital stay were significantly longer in phase 1 than in phase 2, while there was no significant difference in the flap failure rate or follow-up outcomes between the two phases. In summary, the learning curve of mandibular reconstruction with an ICFF stabilized after approximately 17 cases.