Free tissue transfer in head and neck reconstruction: 100 consecutive cases.

Area of Science:

• Microsurgery
• Head and Neck Surgery
• Reconstructive Surgery

Background:

• Free flap reconstruction is crucial for head and neck defects.
• The field is evolving with new techniques and outcomes.
• Assessing survival rates and complications is vital.

Purpose of the Study:

• To critically assess survival rates and complications in free flap reconstruction for head and neck defects.
• To identify technical variables associated with improved outcomes.
• To evaluate the impact of specific surgical techniques on free flap success.

Main Methods:

• A case series of 100 consecutive head and neck microvascular free flap reconstructions.
• Review of medical records for indications, adjuvant/neoadjuvant chemoradiotherapy, complications, and flap outcomes.
• Analysis of flap types (fasciocutaneous, musculocutaneous, osseocutaneous) and reconstruction indications (oncological resection, mandibular reconstruction).

Main Results:

• Overall flap survival rate of 99%.
• Low return-to-theatre rate (6%) for general complications (hematoma) and microvascular anastomosis complications (2%).
• Fasciocutaneous flaps were most common (87%), primarily for oncological resections (86%).

Conclusions:

• Specific technical steps and standardized postoperative monitoring contribute to high flap survival rates.
• Standardized monitoring facilitates communication and early detection of complications.
• Timely intervention is critical for successful free flap outcomes in head and neck reconstruction.