[Use of vascularized free flaps for reconstruction of oncological defects in the head and neck]

The aim of the study is to assess our results with free flap transfer. Since October, 2005 till December, 2011 51 operations were performed. Mucosa of upper digestive tract was reconstructed in 40 cases, soft tissues and skin of the head and neck region-in 11 cases. Reconstruction was primary in all but 2 cases. 18 first cases were performed with 2,5x and 4x binocular loupes magnification. Operating microscope was used in another 33 cases. 37 radial forearm fasciocutaneous flaps, 5 latissimus dorsi musculocutaneous flaps, 7 anterolateral thigh flaps, 1 scapular osteocutaneous were used with the single case of visceral flap--jejunal free flap. Death in early postoperative period occurred once. Complete flap loss occurred six times. Five radial and one latissimus dorsi free flaps were lost. Arterial thrombosis is considered as a primary cause of failure in one case, venous thrombosis-in two cases. Severe postoperative infection was considered as a primary cause of failure in one case. In remaining 2 cases the cause of flap loss could not be determined exactly. There were three cases of revision surgery with attempts to reperform venous anastomosis, one of them was successful. Overall success rate in this series is 86,3 %. The main cause of such a low rate of success is a lack of experience.