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Free Flap Transfer for Head and Neck Reconstruction Using Local Anesthesia in Elderly Patients
Annals of Plastic Surgery
|January 26, 2018
Summary
Free flap reconstruction for head and neck cancer in elderly patients can be safely performed using local anesthesia. This approach avoids general anesthesia risks and complications, offering a viable alternative for high-risk patients.
Area of Science:
- Plastic Surgery
- Oncology
- Anesthesiology
Background:
- Head and neck skin cancer incidence is higher in elderly patients.
- Free flap reconstruction is standard but challenging in elderly patients due to general anesthesia risks.
- This study explores local anesthesia for free tissue reconstruction in this population.
Purpose of the Study:
- To evaluate the feasibility and safety of free flap reconstruction using only local anesthesia in elderly patients with head and neck cancer.
- To assess outcomes and complications in this high-risk patient group.
Main Methods:
- Five elderly patients (mean age 84) with high anesthesia risk underwent head and neck reconstruction with anterolateral thigh or groin free flaps.
- Procedures were performed exclusively under local anesthesia.
- Data collected included patient demographics, anesthesia agents, flap details, operation time, blood loss, and complications.
Main Results:
- All five free flaps survived completely with no complications.
- The mean follow-up period was 26.6 months.
- Successful reconstruction was achieved in all elderly patients.
Conclusions:
- Local anesthesia enables successful free flap reconstruction for head and neck cancer in elderly patients.
- This method offers a safer, less expensive alternative to general anesthesia, expanding treatment options.
- It is particularly beneficial for elderly patients who cannot tolerate general anesthesia.
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