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Porcine As a Training Module for Head and Neck Microvascular Reconstruction

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Chimeric Versus Multiple Simultaneous Free Flaps for Head and Neck Reconstruction.

Johnny Wang¹, Theresa Tharakan¹, Ryan S Jackson¹

¹Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery

|August 8, 2024

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Chimeric flaps offer shorter hospital stays but have a higher major complication rate compared to multiple flaps in head and neck reconstruction. Both techniques are viable, with careful patient selection optimizing outcomes.

Area of Science:

Microsurgery
Head and Neck Reconstruction
Plastic Surgery

Background:

Large head and neck defects present significant reconstructive challenges for microvascular surgeons.
Chimeric and multiple free flaps are surgical techniques used for complex tissue reconstruction.

Purpose of the Study:

To compare surgical outcomes and postoperative complications between chimeric flaps and multiple flaps.
To assess the effectiveness of chimeric flaps versus multiple flaps in head and neck reconstruction.

Main Methods:

Retrospective review of 113 patients undergoing chimeric or multiple simultaneous free tissue transfer (June 2016 - October 2023).
Primary outcome: complication rate (major vs. minor). Secondary outcomes: operative time, length of hospitalization, flap survival.

Keywords:

free flaps head and neck neoplasms postoperative complications

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Main Results:

No significant difference in operative times or minor complications between chimeric and multiple flaps.
Chimeric flaps were associated with a shorter length of hospitalization.
Major complication rate was higher for chimeric flaps (42.1%) compared to multiple flaps (22.7%), P=.03.

Conclusions:

Both chimeric and multiple flaps yield acceptable complication rates when used appropriately for head and neck defects.
Chimeric flaps are a valuable option for patients with prior radiation or radical resection.
Individual patient profiles and institutional capabilities should guide the choice between chimeric and multiple flaps for optimal outcomes.