PD.139 Postoperative complications after surgery and free tissue transfer of tumors in the head and neck region. Results from the study of 70 patients

Large, locally advanced cutaneous malignancy of the head and neck region is rare. However, when present, they impart a significant reconstructive challenge. These cancers have a tendency to invade peripheral tissues covering a large surface area as well as expose deeper structures such as skull, dura, orbit, and sinus after resection. Complicating the reconstructive dilemma is the high incidence of individuals who have undergone previous surgery in the region as well as adjuvant radiation therapy, which may preclude the use of local flaps or skin graft. Free tissue transfer provides a reconstructive surgeon the ability to provide well-vascularized tissue with adequate volume not limited by arc of rotation.

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Microvascular free tissue reconstruction following extirpation of head and neck tumour: experience towards an optimal outcome

The Journal of Laryngology & Otology ◽

10.1258/00222150260369480 ◽

2002 ◽

Vol 116 (11) ◽

pp. 929-936 ◽

Cited By ~ 11

Author(s):

L. K. Lam ◽

William I. Wei ◽

Vana S. H. Chan ◽

Raymond W. M. Ng ◽

W. K. Ho

Keyword(s):

Head And Neck ◽

Neck Region ◽

Free Tissue Transfer ◽

Optimal Outcome ◽

Head And Neck Region ◽

Arterial Inflow ◽

Radial Forearm ◽

Tissue Reconstruction ◽

Cause Of Failure ◽

Surgical Teams

Familiarity with four types of free tissues transfers allows appropriate reconstruction of most defects in the head and neck region functionally and aesthetically. These include jejunal graft, radial forearm, rectus abdominus myocutaneous and fibula osteocutaneous flaps. Free colonic and gastric patches were used occasionally.We report our experience of 215 free tissue transfers for reconstruction of defects in the head and neck region after tumour extirpation.The overall success rate was 94 per cent. The commonest cause of failure was related to arterial inflow (70 per cent). Three patients died in hospital, but their mortality was not related to the tissue transfers. Complications due to free tissue transfer at both the donor and recipient sites were few and manageable.The co-operation between the two surgical teams, together with the timely application of suitable salvage procedures, contribute to an optimal outcome.

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Supraclavicular artery flaps for head and neck reconstruction: a prospective study

International Surgery Journal ◽

10.18203/2349-2902.isj20203794 ◽

2020 ◽

Vol 7 (9) ◽

pp. 3060

Author(s):

Surya Rao Rao Venkata Mahipathy ◽

Alagar Raja Durairaj ◽

Narayanamurthy Sundaramurthy ◽

Anand Prasath Jayachandiran

Keyword(s):

Head And Neck ◽

Neck Region ◽

Free Tissue Transfer ◽

Head And Neck Reconstruction ◽

Head And Neck Region ◽

Complex Anatomy ◽

Reconstructive Option ◽

Good Cosmetic ◽

A Prospective Study ◽

Split Skin

Reconstruction of defects of the head and neck remains a challenge to the reconstructive surgeon. This is due to the complex anatomy of the region as well as the age and comorbidities of the patients, which prevent the use of free tissue transfer as the primary tool of reconstruction. The supraclavicular artery (SCA) island flap is a well vascularised tissue and provides a thin and pliable skin for cutaneous and mucosal defects of the head and neck region. Here, we had done this flap for eight patients with no major complications and hence, we concur that it is a safe, reliable and versatile reconstructive option for these defects. The study period was from January 2015 to June 2016 where we operated on 8 patients, 5 for post burn contracture neck and 3 for post oncologic resection. The flap was used as a pedicled fascio-cutaneous and was based on the transverse supraclavicular artery. Eight cases underwent supraclavicular artery flap of which 5 were males and 3 females. Mean defect size was 15×10 cm. All the donor sites were closed with a split skin graft. One patient had distal necrosis which was managed with debridement and secondary suturing. The supraclavicular artery flap is a thin, versatile, reliable and easy to harvest flap for reconstructing head and neck defects, with good cosmetic and functional outcome.

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