Related Experiment Video
Updated: Jun 19, 2026

Porcine As a Training Module for Head and Neck Microvascular Reconstruction
Published on: September 29, 2018
Predictive Factors of Free Flap Volume Evolution in Head and Neck Reconstruction
Quentin Hennocq1,2, Jean-Baptiste Caruhel3, Mourad Benassarou2
1Sorbonne University, Paris, France.
Objective:
The aim of our study was to determine the factors influencing the evolution of the total volume and bone volume of free flaps commonly used in head and neck surgery, with a 30-month prospective study, to establish volume change predictions and thus propose a degree of overcorrection to be expected before reconstruction.
Study Design:
We prospectively included all consecutive free flap.
Setting:
Our maxillofacial surgery department between August 2021 and January 2024.
Methods:
We collected information on preoperative, per-operative, and postoperative factors, on patients, surgical techniques, and adjuvant treatments. We measured on each postoperative imaging the overall flap volume and bone volume if applicable. Multivariate mixed models were then used to select clinical parameters associated with volume loss.
Results:
We included 166 flaps, performed on 155 patients. The mean age was 60.1 ± 15.1 years. A total of 634 imagings were segmented (487 computed tomography [CT] scans, 77%; 147 magnetic resonance imagings [MRIs], 23%). The use of the superior thyroid or lingual veins for venous anastomosis, such as the use of small couplers, resulted in negative volume changes. Predicted bone volumes decreased by 23% at 30 months for deep circumflex iliac artery (DCIA) free flaps, 19% for fibula free flap (FFF), and 38% for scapular system free flap (SFF).
Conclusion:
These findings allow us to envisage a volume overcorrection of around 60% for fasciocutaneous or osteocutaneous flaps, and 75% for muscle or osteomuscular flaps. The choice of vein and microsurgical technique seems to have more impact on the evolution of free flap volume than patient characteristics or adjuvant treatments.
Related Concept Videos
Bone Remodeling
Internal Forces and Center of Gravity
Internal forces are generated within a body due to the interaction between its particles. These forces can be categorized into tension, compression, and...
Composite Bodies
Composite bodies have widespread applications in mechanical engineering, from automobiles to aircraft to rockets. For example, an automobile wheel comprises...
Deformation of Member under Multiple Loadings
In the case of a member with a variable cross-section, the strain is not constant but depends on the position. The deformation of an...
General Case of Eccentric Axial Loading
Consider a member subjected to equal and opposite forces that are applied along a line that does not coincide with the member's neutral axis. In unsymmetrical bending,...
Conservation of Mass in Fixed, Nondeforming Control Volume
In the case of a sewer pipe, which can be modeled...

