Free flap failure in head and neck reconstruction

Head & Neck ◽  
2014 ◽  
pp. n/a-n/a ◽  
Author(s):  
Christian Corbitt ◽  
Roman J. Skoracki ◽  
Peirong Yu ◽  
Matthew M. Hanasono
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Head And Neck Reconstruction ◽  
Neck Reconstruction ◽  
Flap Failure

scholarly journals Fibula Free Flap in Head and Neck Reconstruction: Identifying Risk Factors for Flap Failure and Analysis of Postoperative Complications in a Low Volume Setting

2019 ◽  
Vol 12 (3) ◽  
pp. 183-192 ◽  
Author(s):  
Pieter-Jan Verhelst ◽  
Flore Dons ◽  
Pieter-Jan Van Bever ◽  
Joseph Schoenaers ◽  
Lloyd Nanhekhan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Head And Neck ◽  
Free Flap ◽  
Head And Neck Reconstruction ◽  
Neck Reconstruction ◽  
Flap Failure ◽  
Fibula Free Flap ◽  
Tertiary Center ◽  
Low Volume

The fibula free flap (FFF) has been a workhorse in maxillofacial reconstruction. High success rates of this technique are reported. However, identifying risk factors for flap failure and analyzing complications can open the way to better patient care. A retrospective analysis was conducted of all FFFs performed over a 20-year period at a low-volume single tertiary center to identify risk factors and postoperative complications. A total of 129 FFFs were included (122 mandible, 7 maxilla). Complete flap failure occurred in 12.4% and partial flap failure in 7.8% of patients. A significant relation was found between younger age and flap failure, and most failures were associated with venous thrombosis. In-hospital surgical complications occurred in 60.5%, in-hospital medical complications in 49.6%, and out-of-hospital complications in 77.5% of patients. The in-hospital reintervention rate was 27.1%, and including salvaged flaps, flap survival rate was 87.6%. Osteomyocutaneous FFF failure (complete 12.4%; partial 7.8%) is an important clinical reality in a low-volume head and neck reconstruction center resulting in an in-hospital reintervention rate of 27.1%. Postoperative complications are frequent, both surgical and out-hospital complications. These results provide a better understanding of the limitations of the FFF in a low-volume center and can be used to optimize care in this kind of setting.

S147 – Pectoralis Major Flaps: A Workhorse in Today's Free Flap Era

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P125-P126
Author(s):  
Barrie Yau-Boon Tan ◽  
Mark Khoo
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Wound Dehiscence ◽  
Pectoralis Major ◽  
Head And Neck Reconstruction ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Recipient Site ◽  
Neck Reconstruction ◽  
Flap Failure

Objectives To study the use, complication rate, and efficacy of pedicled local regional flaps for head and neck reconstruction, and to compare these results with those of microvascular free flap reconstruction. Methods Retrospective analysis of all head and neck oncologic resections requiring flap reconstruction in a tertiary head and neck surgery centre over a 6-year period from 2001–2007. Results In total, 77 operations with flap reconstruction were performed. 44 resections employed pedicled locoregional flaps, comprising 33 pectoralis major, 3 trapezius, 3 cervical rotation, 1 deltopectoral, 1 temporalis muscle, 2 nasolabial, 1 cheek rotation, and 2 bilobed rotation flaps. 2 patients had a combination of 2 regional flaps. There was 1 flap failure. Minor complications occurred in 25% of patients comprising wound seromas (3), wound dehiscence (6), fibrotic band formation (1) and pharyngocutaneous fistula (1). 33 resections employed free flap microvascular reconstructions, comprising 22 free radial forearm, 7 free rectus abdominis, 1 free jejunal, 1 free fibular, and 2 anterolateral thigh flaps. There was 1 flap failure. Minor complications occurred in 33% of patients, comprising donor site wound dehiscence (4), recipient site wound dehiscence or seroma (4), plate extrusion (1), abscess and wound breakdown (2). Conclusions Despite the ready access to free flap reconstruction today, pedicled flaps, especially the pectoralis major flap, remain a major workhorse in head and neck reconstruction. They are hardy, reliable, cost-effective, and can be done in a short operative time. Moreover, for several regions, the functional outcome is no worse than free flap reconstruction.

Buried free flaps in head and neck reconstruction: higher risk of free flap failure?

2016 ◽  
Vol 274 (1) ◽  
pp. 427-430 ◽  
Author(s):  
M. Reiter ◽  
U. Harréus ◽  
U. Kisser ◽  
C. S. Betz ◽  
Ph. Baumeister
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Free Flaps ◽  
Head And Neck Reconstruction ◽  
Neck Reconstruction ◽  
Flap Failure

Risk of Free Flap Failure in Head and Neck Reconstruction

2020 ◽  
Vol 84 ◽  
pp. S3-S6 ◽  
Author(s):  
Kuan-Ying Wang ◽  
Ying-Sheng Lin ◽  
Lee-Wei Chen ◽  
Kuo-Chung Yang ◽  
Wei-Chun Huang ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Head And Neck Reconstruction ◽  
Neck Reconstruction ◽  
Flap Failure

scholarly journals Flap Failure and Salvage in Head and Neck Reconstruction

2020 ◽  
Vol 34 (04) ◽  
pp. 314-320
Author(s):  
Weitao Wang ◽  
Adrian Ong ◽  
Aurora G. Vincent ◽  
Tom Shokri ◽  
Britney Scott ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Surgical Techniques ◽  
Free Tissue Transfer ◽  
Head And Neck Reconstruction ◽  
Success Rates ◽  
Neck Reconstruction ◽  
Flap Failure ◽  
Ablative Surgery ◽  
Reconstructive Option

AbstractWith advanced head and neck ablative surgery comes the challenge to find an ideal reconstructive option that will optimize functional and aesthetic outcomes. Contemporary microvascular reconstructive surgery with free tissue transfer has become the standard for complex head and neck reconstruction. With continued refinements in surgical techniques, larger surgical volumes, and technological advancements, free flap success rates have exceeded 95%. Despite these high success rates, postoperative flap loss is a feared complication requiring the surgeon to be aware of potential options for successful salvage. The purpose of this article is to review free flap failure and ways to optimize surgical salvage in the scenario of flap compromise.

Recipient vessel selection for multiple free flap transfers in head and neck reconstruction at different periods

Microsurgery ◽  
2021 ◽  
Author(s):  
Chih‐Sheng Lai ◽  
Ching‐Hui Shen ◽  
Yi‐Ting Chang ◽  
Shih‐An Liu ◽  
Chen‐Te Lu ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Head And Neck Reconstruction ◽  
Recipient Vessel ◽  
Neck Reconstruction ◽  
Selection For

Fatty tissue atrophy of free flap used for head and neck reconstruction

Microsurgery ◽  
2010 ◽  
Vol 31 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Masaki Fujioka ◽  
Kana Masuda ◽  
Yoshinobu Imamura
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Head And Neck Reconstruction ◽  
Fatty Tissue ◽  
Neck Reconstruction

Free flap head and neck reconstruction: Feasibility in older patients

2019 ◽  
Vol 10 (4) ◽  
pp. 577-583 ◽  
Author(s):  
Aurélie Parsemain ◽  
Pierre Philouze ◽  
Pierre Pradat ◽  
Philippe Ceruse ◽  
Carine Fuchsmann
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Older Patients ◽  
Head And Neck Reconstruction ◽  
Neck Reconstruction
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