Multiple Sequential Free Flap Reconstructions of the Head and Neck: A Single-Center Experience.
Plast Reconstr Surg
; 148(5): 791e-799e, 2021 Nov 01.
Article
in En
| MEDLINE
| ID: mdl-34586092
ABSTRACT
BACKGROUND:
Free flap reconstruction is the standard of care in extensive defects of the head and neck area, and although most patients may be treated sufficiently with one flap, recurrence of a malignant tumor or failure of a previous reconstruction may make the use of a second (or more) flap necessary. The aim of this study was to evaluate the indications and success rates of multiple consecutive reconstructive procedures in a large cohort of patients.METHODS:
Nine hundred ninety-six free flap reconstructions were retrospectively analyzed and cases of sequential reconstructions in the same patient were identified. Indications, success rates, perioperative procedures, and frequently used flaps were evaluated.RESULTS:
Two hundred twenty cases of sequential microvascular reconstructions were identified, ranging from two to six flaps per patient. The overall flap success rate was 89.1 percent. A history of diabetes was identified as a risk factor for flap failure (p = 0.029). There was no association of flap loss with the number of reconstructive procedures per patient.CONCLUSIONS:
The use of several free flaps in the same patient is a feasible option for patients suffering from recurrent tumors or to improve quality of life by a secondary reconstruction. A salvage free flap transfer to replace a lost transplant exhibits good success rates. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Plastic Surgery Procedures
/
Free Tissue Flaps
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Surgical Wound
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Head and Neck Neoplasms
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Neoplasm Recurrence, Local
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Patient_preference
Limits:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Plast Reconstr Surg
Year:
2021
Document type:
Article