Does Cigarette Smoking Harm Microsurgical Free Flap Reconstruction?

2018 ◽  
Vol 34 (07) ◽  
pp. 492-498 ◽  
Author(s):  
Paul Heidekrueger ◽  
Elisabeth Haas ◽  
Michaela Coenen ◽  
Riccardo Giunta ◽  
Milomir Ninkovic ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
Free Flap ◽  
Smoking Status ◽  
Free Flaps ◽  
Negative Influence ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Wide Range ◽  
American Society ◽  
The Impact

Background Free tissue transfers can successfully address a wide range of reconstructive requirements. While the negative influence of cigarette smoking is well documented, its effects in the setting of microsurgical free flap reconstruction remain debated. This study evaluates the impact of cigarette smoking on microsurgical reconstructions. Methods Over a 7-year period, 897 patients underwent 969 microvascular free flap reconstructions at a single surgical center. The cases were divided into “smoker” (S) and “nonsmoker” (NS) groups according to their cigarette smoking status. The data were retrospectively screened for patients' demographics, perioperative details, surgical complications, free flap types, recipient sites, flap survival, and overall outcomes. Results Both groups were comparable regarding comorbidities including hypertension, peripheral artery disease, diabetes, American Society of Anesthesiologists scores, types of performed free flaps, and recipient sites. While patients in the NS group were significantly older and had a higher prevalence of obesity (p < 0.05), there were no significant differences regarding the rate of major or minor complications during our 3-month follow-up period (p > 0.05). Conclusion While minor and major complications were increased regarding virtually all examined parameters, cigarette smoking did not have significant effects on the overall outcomes of microsurgical free flap reconstructions.

scholarly journals Use of the Anterolateral Thigh in Cranio-Orbitofacial Reconstruction

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
William J. Parkes ◽  
Howard Krein ◽  
Ryan Heffelfinger ◽  
Joseph Curry
Keyword(s):  
Free Flap ◽  
Case Series ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Tissue Loss ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Anterolateral Thigh ◽  
The Many ◽  
Soft Tissue Loss

Objective. To detail the clinical outcomes of a series of patients having undergone free flap reconstruction of the orbit and periorbita and highlight the anterolateral thigh (ALT) as a workhorse for addressing defects in this region. Methods. A review of 47 patients who underwent free flap reconstruction for orbital or periorbital defects between September 2006 and May 2011 was performed. Data reviewed included demographics, defect characteristics, free flap used, additional reconstructive techniques employed, length of stay, complications, and follow-up. The ALT subset of the case series was the focus of the data reviewed for this paper. Selected cases were described to highlight some of the advantages of employing the ALT for cranio-orbitofacial reconstruction. Results. 51 free flaps in 47 patients were reviewed. 38 cases required orbital exenteration. The ALT was used in 33 patients. Complications included 1 hematoma, 2 wound infections, 3 CSF leaks, and 3 flap failures. Conclusions. Free tissue transfer allows for the safe and effective reconstruction of complex defects of the orbit and periorbital structures. Reconstructive choice is dependent upon the extent of soft tissue loss, midfacial bone loss, and skullbase involvement. The ALT provides a versatile option to reconstruct the many cranio-orbitofacial defects encountered.

Analysis of the impact of chronic corticosteroid use on free flap reconstruction

Microsurgery ◽  
2019 ◽  
Author(s):  
Joseph S. Weisberger ◽  
Nicholas C. Oleck ◽  
Haripriya S. Ayyala ◽  
Radhika Malhotra ◽  
Edward S. Lee
Keyword(s):  
Free Flap ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Chronic Corticosteroid ◽  
The Impact

scholarly journals 0660 The Association Between Sleep-Related Breathing Disorders and Free Flap Reconstruction Surgery in Patients With Oral and Oropharyngeal Cancers During 6-Month Follow-Up

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A252-A252
Author(s):  
L Fu-Hsin ◽  
C Chan-Chi ◽  
L Yu-Cheng ◽  
L Wei-Shu ◽  
L Cheng-Yu
Keyword(s):  
Free Flap ◽  
Apnea Hypopnea Index ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Sleep Related Breathing Disorders ◽  
Reconstruction Surgery ◽  
Breathing Disorders ◽  
Significant Difference ◽  
Before And After ◽  
The Impact

Abstract Introduction Little was known about the association between sleep-related breathing disorders (SRBDs) and oral and oropharynx cancers (OOCs). To clarify the impact of free flap reconstruction on SRBDs, we performed a pilot study to investigate the change of SRBDs severity in patients with OOC before and after flap reconstruction surgery. Methods This study recruited 15 patients who were newly diagnosed with OOCs and expected to receive free flap reconstruction surgery. For each participant, polysomnography tests were performed repeatedly at the time of pre-operative, post-operative 1-week, and post-operative 6-month periods. Results All the subjects were male. Median age was 56 years (range 37-68). Mean of body mass index (BMI) was 24.5 (SD 5.8). Pre-operative apnea-hypopnea index (AHI) was 21.1/hour (SD 20.1). During post-operative 1-week period, BMI was 24.1(SD 5.8) and AHI was 40.2/hour (SD 27.9). During post-operative 6-month period, BMI was 23.4 (SD 3.3) and AHI was 33.3/hour (SD 21.6). Comparison between pre-operative and post-operative 6-month periods, there was no significant difference in BMI, but AHI increased significantly (21.1/hour v.s. 33.3/hour, P = 0.01). Conclusion Our study showed that OOCs patients with free flap reconstruction surgery had significantly increased AHI level during post-operative 1-week period. The SRBDs severity became partial remission after 6 months. We recommend that the head and neck cancer team should pay attention to the SRBDs issues in OOCs patients with free flap reconstruction surgery. Support  

scholarly journals Reconstruction with free flaps in robotic head-and-neck onco-surgeries

2018 ◽  
Vol 51 (03) ◽  
pp. 283-289 ◽  
Author(s):  
Rajan Arora ◽  
Vinay Kumar Verma ◽  
Kripa Shanker Mishra ◽  
Hemant Bhoye ◽  
Rahul Kapoor
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Dissection ◽  
Neck Cancer ◽  
Free Flap ◽  
Free Flaps ◽  
Cancer Surgery ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Good Outcome

ABSTRACT Aims and Objective: The aim of the present article is to highlight how reconstruction with free flaps is different and difficult in cases with robotic head-and-neck cancer surgery. It also highlights the technical guidelines on how to manage the difficulties. Materials and Methods: Eleven patients with oropharyngeal cancer having undergone tumour excision followed by free-flap reconstruction been reviewed here. Nine patients had tumour excision done robotically through intraoral route while neck dissection done with transverse neck crease incision. There is a problem of difficult flap inset in this group of patient. Two patients had intraoral excision of tumour followed by robotic neck dissection via retroauricular incision. With no incision directly on the neck, microvascular anastomosis is challenging in this set of patients. Free flap was used in all the cases to reconstruct the defect. Results: Successful reconstruction with free flap was done in all the cases with good outcome both functionally and aesthetically. Conclusion: Free-flap reconstruction is possible in robotic head-and-neck cancer surgery despite small and difficult access, but it does need practice and some technical modifications for good outcome.

O147 The use of free flaps based on the thoracodorsal artery for free flap reconstruction

2007 ◽  
Vol 2 (1) ◽  
pp. 109
Author(s):  
R. Anand ◽  
M. Ethunandan ◽  
P. Ramchandani ◽  
V. Ilankovan
Keyword(s):  
Free Flap ◽  
Free Flaps ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Thoracodorsal Artery

Sensory topography of the oral cavity and the impact of free flap reconstruction: A preliminary study

Head & Neck ◽  
2004 ◽  
Vol 26 (10) ◽  
pp. 884-889 ◽  
Author(s):  
Karen B. Zur ◽  
Eric M. Genden ◽  
Mark L. Urken
Keyword(s):  
Oral Cavity ◽  
Free Flap ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Preliminary Study ◽  
The Impact

498 The Bristol Sign - A Technical Tip to Confirm Skin Flap Vascularity

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Timothy Schrire ◽  
Ahmed Emam ◽  
Giulia Colavitti ◽  
Umraz Khan
Keyword(s):  
Free Flap ◽  
Gold Standard ◽  
Skin Flap ◽  
Free Flaps ◽  
Modern Medicine ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Central Tenet ◽  
Tissue Defects

Abstract Introduction In modern medicine, free flap reconstruction has become the gold standard when faced with soft tissue defects. The impressive cosmesis, and adaptability of free flaps means that we can securely state that we are in the era of Plastic Surgery defined by free flap reconstruction. However, as part of free flap reconstruction, clinical monitoring of the flap is a central tenet post-operatively. Different departments have different protocols for this. Method In our unit, it is practice to insert a single interrupted stitch overlying the Doppler site just before dressings. This localises the site of the pedicle for Doppler monitoring, and allows the surgeon to examine the quality of the blood droplets, demonstrating flap perfusion. Results The use of the stitch is considered practical, replicable, and safe, and aids in providing gold standard monitoring post-operatively. The additional analysis of the blood droplet is another sign, in itself, of a healthy flap, and excludes venous congestion. Conclusions The Bristol stitch is a useful adjunct to free flap reconstruction. It’s localisation of the Doppler signal allows medical and nursing staff to confidently approach post-operative monitoring, and the blood elicited by the stitch insertion is a useful sign of flap vascularity and venous status.

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