Related Experiment Video
Updated: Mar 9, 2026
Murine Full-thickness Skin Transplantation
Published on: January 2, 2017
Outcomes of microvascular free tissue transfer in twice-irradiated patients
Kate Clancy1, Sami Melki2, Musaddiq Awan3
1Case Western Reserve School of Medicine, Cleveland, Ohio.
Background:
Patients may require microvascular free tissue transfer (MFTT) following re-irradiation for recurrent cancer or radiation complications. The objective of this study was to describe the indications for and outcomes of free flaps performed in twice-radiated patients.
Methods:
A retrospective chart review identified the indications for and outcomes of 36 free flaps performed on 29 twice-irradiated patients.
Results:
The free flap success rate was 92%. The most common indications requiring MFTT were cancer recurrence and osteoradionecrosis. Sixty-one percent experienced postoperative complications, most commonly wound infection (33%). Twenty-five percent of the procedures required return to the operating room due to postoperative complication.
Conclusions:
MFTT can be successfully performed in the twice-irradiated patient population with a success rate comparable to singly-radiated patients. Despite a high success rate, there is also a high rate of surgical site complications, especially infection.
Insights
Microvascular free tissue transfer (MFTT) is successful in patients who have undergone re-irradiation. While outcomes are comparable to singly-radiated patients, surgical site infections are common.
Area of Science:
- Reconstructive surgery
- Oncology
- Radiation oncology
Background:
- Re-irradiation for cancer recurrence or complications necessitates microvascular free tissue transfer (MFTT).
- Evaluating MFTT outcomes in twice-radiated patients is crucial for treatment planning.
Purpose of the Study:
- To describe the indications for MFTT in twice-radiated patients.
- To report the outcomes of free flaps in this patient population.
Main Methods:
- Retrospective chart review of 36 free flaps in 29 twice-radiated patients.
- Analysis of indications, success rates, and postoperative complications.
Main Results:
- Overall free flap success rate was 92%.
- Common indications included cancer recurrence and osteoradionecrosis.
- Postoperative complications occurred in 61%, with wound infection being most frequent (33%).
- 25% of procedures required reoperation due to complications.
Conclusions:
- MFTT is a viable option for twice-radiated patients, achieving success rates similar to singly-radiated patients.
- High rates of surgical site complications, particularly infection, necessitate careful management.
