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Engineered Vascularized Muscle Flap
Published on: January 11, 2016
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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
Summary
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.
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.
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