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Porcine As a Training Module for Head and Neck Microvascular Reconstruction
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Pediatric Head & Neck Free-Flap Reconstruction Outcomes: Score-Based Effectiveness Assessment
Maciej Borowiec1, Dominika Lech2, Robert Maksymowicz2
1Head and Neck Surgery Clinic for Children and Young Adults, Regional Specialized Children's Hospital in Olsztyn, 18a Żołnierska Str., 10-561 Olsztyn, Poland.
Journal of Clinical Medicine
|February 13, 2026
Summary
Pediatric head and neck reconstruction using microsurgical free flaps is safe and effective across all ages. A comprehensive scoring system shows high functional recovery rates, exceeding simple flap survival metrics.
Area of Science:
- Plastic Surgery
- Pediatric Surgery
- Head and Neck Surgery
Background:
- Microsurgical free-flap reconstruction is crucial for pediatric head and neck defects.
- Existing outcome data are limited, focusing mainly on technical survival.
- A standardized Treatment Effectiveness Score (TES) was developed to assess clinical effectiveness.
Purpose of the Study:
- To evaluate the clinical effectiveness of microsurgical free-flap reconstruction in pediatric patients.
- To assess functional recovery using a standardized Treatment Effectiveness Score.
- To analyze the impact of patient age on outcomes.
Main Methods:
- Retrospective review of 54 free-flap procedures in 46 pediatric patients (16 months-18 years).
- Systematic assessment of recipient- and donor-site outcomes, swallowing, mastication, breathing, and mouth opening.
- Analysis of age as a modifying variable for flap survival and treatment effectiveness.
Main Results:
- Flap survival rate was 76%; mean TES was 89.7 in cases without flap loss.
- Partial complications occurred in 37% of procedures; donor-site morbidity was 5.6%.
- 80.4% of patients achieved full functional restoration; age did not significantly impact outcomes.
Conclusions:
- Pediatric microsurgical reconstruction is safe and feasible across the age spectrum.
- Composite outcome scoring (TES) offers a more comprehensive assessment than flap survival alone.
- Standardized reporting frameworks are needed for future pediatric reconstruction studies.
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