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Published on: November 8, 2019
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Microvascular Reconstruction: Evidence-Based Procedures
Steven B Cannady1, Eric Lamarre2, Mark K Wax3
1Department of Otolaryngology-HNS, University of Pennsylvania, Houston Hall, 3417 Spruce Street, Philadelphia, PA 19104, USA.
Facial Plastic Surgery Clinics of North America
|July 26, 2015
Summary
Microvascular free tissue transfer effectively reconstructs complex defects, aiding healing and function. This review covers monitoring, mandibular reconstruction options (fibula vs. radial forearm), and outcomes for head and neck reconstructions.
Area of Science:
- Plastic Surgery
- Head and Neck Surgery
- Reconstructive Surgery
Background:
- Microvascular free tissue transfer is crucial for replacing extensive composite tissue defects.
- Successful reconstruction impacts wound healing, functional recovery, rehabilitation, and cosmetic results.
- Tissue can be customized and sourced from unradiated areas, preserving reconstructive options.
Purpose of the Study:
- To review the current evidence and practices for microvascular free tissue transfer in head and neck reconstruction.
- To discuss postoperative monitoring strategies for free tissue transfers.
- To compare lateral mandibular reconstruction techniques using fibula versus radial forearm flaps and evaluate functional outcomes.
Main Methods:
- Literature review focusing on postoperative monitoring, mandibular reconstruction techniques, and functional outcomes.
- Comparative analysis of fibula free flap versus radial forearm free flap for lateral mandibular reconstruction.
- Synthesis of evidence regarding the efficacy of free tissue transfer in head and neck defects.
Main Results:
- Postoperative monitoring is essential for early detection of free tissue transfer complications.
- Both fibula and radial forearm flaps are viable options for lateral mandibular reconstruction, each with specific advantages.
- Functional outcomes and patient satisfaction vary depending on the defect and reconstruction method.
Conclusions:
- Microvascular free tissue transfer remains a cornerstone for complex head and neck defect reconstruction.
- Careful patient selection, surgical technique, and vigilant postoperative monitoring are critical for successful outcomes.
- Further high-level evidence is needed to definitively guide reconstructive choices in specific head and neck scenarios.
