Assessment of perfusion of free flaps used in head and neck reconstruction using pulsatility index

ABSTRACTObjective: To detect venous or arterial obstruction in the pedicle of a free flap we can monitor resistance in the flap bed which is reflected in Pulsatility Index (PI) Therefore if we detect change in the values of the PI in these flaps then we can detect complications in flap due to vascular insufficiency early. Materials and Methods: Seven patients of Free Fibular Flap Reconstruction and ten patients of Free Radial Forearm Flap reconstruction were evaluated over a period of 18 months. In the pre op we recorded PI of Radial and Peroneal artery using colour doppler study. In the Post Operative Period 2 readings of PI at the anastomotic site were taken on Day 1 and Day 7. Results: Both Free Radial Forearm and Free Fibula flaps which were healthy (n = 15) showed a significant decrease in PI values on first Post Op day as compared to Pre Op. Also there was a significant fall in PI on Post Op Day 7 as compared to post op Day 1 (P < 0.05) in these flaps. The flaps developing complications (n = 2) had significantly higher Day 1 Post op PI readings as compared to healthy flaps (P < 0.05). Conclusion: PI is an objective index which can indicate changes in perfusion of free flaps used in Head and Neck reconstruction based on which we can predict if a flap is susceptible to circulatory compromise.

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Comparison of Anterolateral Thigh and Radial Forearm Free Flaps in Head and Neck Reconstruction

In Vivo ◽

10.21873/invivo.11325 ◽

2018 ◽

Vol 32 (4) ◽

pp. 893-897 ◽

Cited By ~ 3

Author(s):

CARLO M. ORANGES ◽

BARBARA LING ◽

MATHIAS TREMP ◽

RETO WETTSTEIN ◽

DANIEL F. KALBERMATTEN ◽

...

Keyword(s):

Head And Neck ◽

Free Flaps ◽

Head And Neck Reconstruction ◽

Neck Reconstruction ◽

Anterolateral Thigh ◽

Radial Forearm

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The proximal peroneal artery perforator flap: an alternative to the radial forearm flap for head and neck reconstruction

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2017.02.639 ◽

2017 ◽

Vol 46 ◽

pp. 187

Author(s):

S. Mattine

Keyword(s):

Head And Neck ◽

Perforator Flap ◽

Radial Forearm Flap ◽

Peroneal Artery ◽

Head And Neck Reconstruction ◽

Forearm Flap ◽

Neck Reconstruction ◽

Radial Forearm ◽

Artery Perforator

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Anterolateral thigh free flaps and radial forearm free flaps in head and neck reconstruction: A 20-year analysis from a single institution

Archives of Plastic Surgery ◽

10.5999/aps.2020.01529 ◽

2021 ◽

Vol 48 (1) ◽

pp. 49-54

Author(s):

Simon Yang ◽

Jong Won Hong ◽

In Sik Yoon ◽

Dae Hyun Lew ◽

Tai Suk Roh ◽

...

Keyword(s):

Head And Neck ◽

Donor Site ◽

Free Flaps ◽

Cancer Site ◽

Head And Neck Reconstruction ◽

Single Institution ◽

Reconstruction Surgery ◽

Neck Reconstruction ◽

Anterolateral Thigh ◽

Radial Forearm

Background Reconstruction after removal of a malignant tumor in the head and neck region is crucial for restoring tissue integrity, function, and aesthetics. We retrospectively analyzed patients who underwent intraoral reconstruction surgery using radial forearm free flaps (RFFF) and anterolateral thigh free flaps (ALT) at a single institution to provide more information supporting the choice of a reconstruction method after removal of head and neck cancer.Methods The charts of 708 patients who underwent head and neck reconstruction between 1998 and 2018 at the Department of Plastic and Reconstructive Surgery at our institution were retrospectively reviewed. Patients’ age, sex, and history of radiation therapy, diabetes mellitus, and smoking were retrieved. The primary cancer site, types of defects, and complications were investigated.Results Overall, 473 and 95 patients underwent reconstruction surgery with RFFF and ALT, respectively. RFFF was more often used in patients with cancers of the pharynx, larynx, esophagus, or tonsil, while ALT was more frequently used in patients with cancers of the mouth floor with tonsil or tongue involvement. The proportion of patients undergoing ALT increased gradually. Flap failure and donor site morbidities did not show significant differences between the two groups.Conclusions RFFF and ALT flaps resulted in similar outcomes in terms of flap survival and donor site morbidity. ALT can be an option for head and neck reconstruction surgery in patients with large and complex defects or for young patients who want to hide their donor site scars.

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