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Engineered Vascularized Muscle Flap
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Microvascular Surgeons: The Second Victim With Free Flap Failure.

Matthew B Studer1, Alexandra Hoffman2, Regina Elmudesi Del Rio3

  • 1Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA.

The Laryngoscope
|August 27, 2025
PubMed
Summary
This summary is machine-generated.

Microvascular surgeons experience significant emotional distress, known as second victim syndrome, after free flap failure. Early interventions within six months are crucial for supporting surgeons through these challenging events.

Keywords:
burn outhead and neck malignancymicrovascular reconstruction and second victim

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Area of Science:

  • Microsurgery and Surgical Outcomes
  • Healthcare Professional Well-being
  • Psychological Impact of Medical Errors

Background:

  • Second victim syndrome (SVS) affects healthcare providers after patient complications, causing anxiety, depression, and shame.
  • Free flap failure in microsurgery can be a significant source of trauma for surgeons.
  • Understanding the emotional impact on microsurgeons is vital for developing targeted support systems.

Purpose of the Study:

  • To investigate the emotional responses of microvascular surgeons to free flap failure.
  • To identify the emotional support systems utilized by microvascular surgeons.
  • To explore demographic and practice-related factors influencing these responses.

Main Methods:

  • A twenty-question survey was administered to microvascular surgeons.
  • The survey assessed participant demographics, practice dynamics, emotional responses to free flap failure, and support systems.
  • Data from 93 completed surveys were analyzed.

Main Results:

  • A high percentage of surgeons reported anxiety (74%), guilt (70%), sadness (68%), shame (63%), and doubt (51%) after flap failure.
  • Female surgeons were more likely to report sadness and doubt their skills compared to males.
  • Women found therapists and online forums more effective support systems than men.
  • Surgeons experiencing recent flap failure desired reduced caseloads.

Conclusions:

  • Free flap failure triggers second victim syndrome in microvascular surgeons across diverse backgrounds.
  • The initial six months post-failure represent a critical window for implementing supportive interventions.
  • Addressing the psychological impact of SVS is essential for the well-being of microsurgical teams.