[Free composite flap transfers in the head and neck region: an 8-year experience]

To analyze the feasibility and reliability of free tissue flap transfers in the head and neck region.

One thousand five hundred and eighty-four consecutive free flap transfers performed in 1,501 patients from May 1999 to September 2007 were reviewed. Among the 1,501 patients, 918 were male and 583 were female. The age range was 5 to 86, with the average of 45.8 years. Data concerning the operation included date of surgery, defect description and site, stage and histology of tumor, flap type, recipient vessel, rate of postoperative vessel thrombosis and salvage rate.

There were ten kinds of free flaps in this group, with the free fibula flap most commonly used, followed by free radial forearm flap, rectus abdominis flap, free jejunum flap, anterolateral thigh free flap, iliac crest flap, scapular flap, latissimus dorsi flap, lateral arm flap, and ileocecal flap. The overall success rate of flaps was 98.1% (1,554/1,584). Fifty-five cases developed vessel thrombosis after operation, 40 were venous and 13 were arterial. The rate of vessel thrombosis was 3.3% (53/1,584), and the salvage rate was 43.4% (23/53).

Free tissue flap transfer in the head and neck region is feasible and reliable, and further application of simplified technique of head and neck microsurgery is necessary.