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Microvascular free flaps in head and neck surgery

M Macnamara1, S Pope, A Sadler

  • 1Ferens Institute of Otolaryngology, Department of Plastic Surgery, Middlesex Hospital, London.

The Journal of Laryngology and Otology
|November 1, 1994
PubMed
Summary

This study on head and neck microvascular free flap reconstruction found that while smoking and age weren't risk factors, vascular disease, cardiac issues, and alcohol withdrawal increased flap failure. The radial forearm flap showed the best outcomes.

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Area of Science:

  • Plastic Surgery
  • Head and Neck Surgery
  • Microsurgery

Background:

  • Microvascular free flap reconstruction is crucial for head and neck defects.
  • Understanding risk factors and outcomes is essential for improving patient results.

Purpose of the Study:

  • To analyze outcomes and complications of microvascular free flap reconstructions in the head and neck.
  • To identify pre-operative risk factors associated with flap failure.

Main Methods:

  • Retrospective review of 60 patients undergoing head and neck microvascular free flap reconstructions.
  • Data collected over a 10-year period by a single surgeon, including flap types, complications, and outcomes.
  • Analysis of pre-operative risk factors such as smoking, age, peripheral vascular disease, cardiac disease, and alcohol withdrawal.

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Main Results:

  • Smoking and advanced age did not significantly impact flap survival.
  • Peripheral vascular disease, cardiac disease, and alcohol withdrawal were associated with increased flap failure.
  • The most common complications were anastomosis thrombosis and hematoma.
  • The radial forearm flap demonstrated superior survival and functional outcomes.

Conclusions:

  • Certain comorbidities significantly increase the risk of microvascular free flap failure in head and neck reconstruction.
  • The radial forearm flap is a reliable option for head and neck reconstruction.
  • Further research into optimizing patient selection and peri-operative management is warranted.