Free flaps and literature review

Area of Science:

• Reconstructive Surgery
• Microsurgery
• Head and Neck Surgery

Background:

• Microvascular free flaps are a standard for head and neck defect reconstruction.
• This study details 169 free flap procedures to assess reconstruction success rates.

Purpose of the Study:

• To evaluate the success rate of microvascular free flap reconstructions.
• To identify factors influencing flap and overall complications in head and neck reconstructions.

Main Methods:

• Analysis of 169 microsurgical reconstructions for head and neck defects (1994-2012).
• Evaluation of patient demographics (age, sex, ASA score), lifestyle factors (smoking), prior radiotherapy, and deep circumflex iliac artery (DCIA) harvesting technique.
• Assessment of influences on flap and overall complication rates.

Main Results:

• A 92% flap success rate was observed in 169 procedures.
• Systemic complications occurred in 21% of cases.
• The DCIA split harvesting technique and increased patient age were significantly associated with higher complication rates.

Conclusions:

• The DCIA split harvesting technique correlated with a higher frequency of flap failure, primarily due to hematomas impacting venous circulation.
• Advanced patient age was identified as a significant predictor of postoperative complications.