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Multiple simultaneous free flaps for head and neck reconstruction: A multi-institutional cohort
Theresa Tharakan1, Gifty Marfowaa2, Kenneth Akakpo2
1Department of Otolaryngology- Head and Neck Surgery, Washington University in St Louis School of Medicine, St Louis, MO, United States.
Oral Oncology
|December 3, 2022
Summary
Multiple, simultaneous free flaps offer a reliable option for complex head and neck reconstruction. This technique demonstrated a high success rate in patients with extensive defects, showcasing its efficacy in challenging cases.
Area of Science:
- Plastic Surgery
- Head and Neck Surgery
- Reconstructive Surgery
Background:
- Complex head and neck defects often require extensive reconstruction.
- Multiple free flaps can address defects involving diverse tissue types and large volumes.
Purpose of the Study:
- To evaluate the experience of two academic centers using multiple, simultaneous free flaps for head and neck reconstruction.
- To assess the outcomes and reliability of this reconstructive approach.
Main Methods:
- Retrospective review of 71 patients undergoing multiple, simultaneous free flaps between 2017 and 2022.
- Analysis of patient demographics, defect characteristics, flap types, operative times, and outcomes.
Main Results:
- 143 free flaps were performed, primarily for squamous cell carcinoma (67.6%).
- Common flap combinations included fibula (FFF) with anterolateral thigh and radial forearm (RFFF) with scapula.
- A high flap survival rate of 98.6% was observed at a median follow-up of 6 months.
Conclusions:
- Multiple, simultaneous free flaps are a rare but reliable reconstructive option for select head and neck defects.
- This approach is effective for defects involving multiple tissue types, functional areas, or large volumes.
