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Second free flaps in head and neck reconstruction

A A Amin¹, B J Baldwin, A Gürlek

¹Department of Plastic Surgery, University of Texas M.D. Anderson Cancer Center, Houston, USA.

Journal of Reconstructive Microsurgery

|September 12, 1998

Summary

Second free flaps offer a high success rate for head and neck reconstruction, serving as a vital option for salvage or aesthetic enhancement after initial free tissue transfer procedures.

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Area of Science:

Plastic Surgery
Head and Neck Surgery
Reconstructive Surgery

Background:

Free-tissue transfer has significantly advanced head and neck reconstruction quality.
Second free flaps are increasingly utilized for aesthetic refinement and salvage.

Purpose of the Study:

To evaluate the indications, outcomes, and success rates of second free flaps in head and neck reconstruction.
To analyze risk factors, recipient vessel usage, and complications associated with secondary reconstructions.

Main Methods:

Retrospective review of 28 patients undergoing second free flaps for head and neck reconstruction.
Classification of flaps as immediate (within 72 hours) or delayed (within 2 years).
Analysis of indications, recipient vessels, outcomes, and complications.

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Main Results:

A 96% success rate was observed for second free flaps.
Indications included salvage (9 immediate), soft-tissue defect reconstruction (3 immediate), recurrent tumor excision (2 delayed), and aesthetic improvement (14 delayed).
Identical recipient vessels were frequently reused for both first and second flaps.

Conclusions:

Second free flaps are a valuable tool for salvaging or improving head and neck reconstructions in select patients.
The reuse of recipient vessels is feasible and effective for secondary reconstructions.
Careful patient selection is key to successful secondary free flap procedures.