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Free flap surgery in Europe: an interdisciplinary survey
C Rendenbach1, N Hölterhoff2, S Hischke3
1Department of Oral and Maxillofacial Surgery, Charité - Universtätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany.
International Journal of Oral and Maxillofacial Surgery
|December 26, 2017
Summary
Perioperative free flap surgery management shows broad anticoagulant use and prolonged antibiotic prophylaxis. Osseous reconstruction presents the most significant challenges in free flap procedures.
Area of Science:
- Surgical Reconstruction
- Perioperative Care
- Craniomaxillofacial Surgery
Background:
- Free flap surgery is crucial for aesthetic and functional body reconstruction.
- Understanding perioperative management variations is key for optimizing outcomes.
Purpose of the Study:
- To compare perioperative free flap management concepts among ENT, craniomaxillofacial, and plastic surgeons.
- To identify differences and commonalities in surgical practices.
Main Methods:
- A European survey was conducted across 570 surgical departments.
- 172 medical units participated, detailing antibiotic/antithrombotic use, osseous reconstruction, and flap monitoring.
Main Results:
- A wide range of anticoagulant regimens and prolonged antibiotic prophylaxis were observed.
- CAD/CAM plates were favored for mandibular fixation; visual assessment and Doppler for monitoring.
- Higher flap loss rates were reported following osseous reconstruction.
Conclusions:
- Few significant differences in perioperative management were found between surgical specialties.
- Osseous reconstruction in free flap surgery is identified as the most challenging aspect.
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