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Porcine As a Training Module for Head and Neck Microvascular Reconstruction
Published on: September 29, 2018
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Free flap reconstruction following head and neck trauma
Larissa Sweeny1,2, Anne C Kane3, Carissa M Thomas4
1Department of Otolaryngology - Head and Neck Surgery, University of Miami, Miami, Florida, USA.
Head & Neck
|July 10, 2024
Summary
Free flap reconstruction for head and neck trauma is rare, with failures primarily in gunshot wound cases involving multiple sites. Preoperative antibiotics reduced complications and readmissions.
Area of Science:
- Reconstructive surgery
- Trauma surgery
- Head and neck surgery
Background:
- Free flap (FF) reconstruction is infrequently used for head and neck traumatic injuries.
- This study examines FF reconstruction outcomes in a cohort of 103 patients with traumatic injuries.
Purpose of the Study:
- To analyze the incidence and causes of free flap failures in head and neck trauma reconstruction.
- To identify factors associated with free flap success and complications, including the role of preoperative antibiotics.
Main Methods:
- A multi-institutional retrospective case series was conducted involving 103 patients who underwent free flap reconstruction for traumatic injuries.
- Data collected included injury mechanisms, reconstruction types, flap outcomes, and postoperative complications.
Main Results:
- Gunshot wounds (GSW) constituted 85% of injuries, with most patients (82%) undergoing osseous reconstruction.
- Free flap failures occurred in 9% of cases, exclusively in GSW patients and often involving multiple injured subsites.
- Preoperative antibiotics were linked to significantly lower rates of neck washouts (4% vs. 19%) and 30-day readmissions (4% vs. 17%).
Conclusions:
- Free flap failures in head and neck trauma are predominantly associated with GSW and injuries to multiple anatomical subsites.
- The use of preoperative antibiotics correlates with reduced need for postoperative washout procedures and fewer 30-day readmissions, suggesting a beneficial role in managing these complex reconstructions.
