Head & Neck · 2013 · 125 citations · 30 references
MedicineNeck SurgeryPlastic SurgeryMicrosurgeryPharyngeal SurgeryReconstructive SurgeryFlap ReconstructionFlap SalvageFlap SurgeryFree Flap ReconstructionMicrovascular Free-flap ReconstructionPharyngeal ReconstructionFree Flap FailureFree Flap Pharyngeal ReconstructionFunctional Outcomes After ReconstructionFunctional Outcomes After SurgeryPectoralis Major Flap ReconstructionPectoralis Major Myocutaneous FlapPharyngeal Defect ReconstructionPharyngeal Flap Reconstruction
BACKGROUND: The purpose of this study was to determine the causes of head and neck free flap loss and to evaluate outcomes after subsequent microvascular and non-microvascular reconstruction. METHODS: Patients who experienced free flap loss between 2000 and 2012 were reviewed. RESULTS: There were 40 flap losses out of 3090 free flaps (1.3%). Twenty-eight patients underwent subsequent free flap reconstruction of which 27 free flaps were successful (96.4%), which was not significantly different from our initial flap success rate (p = .81). Of patients who underwent subsequent free flap reconstruction for oral/pharyngeal defects, 100% had >80% speech intelligibility and 87.5% were tube feed independent. By comparison, 42.9% of patients who underwent subsequent pectoralis major flap reconstruction had intelligible speech (p = .01) and 25.0% were independent of tube feeds (p = 0.02). CONCLUSION: Subsequent free flaps after initial free flap losses can be successful in selected patients. Functional outcomes after subsequent free flap reconstruction are favorable compared to pedicled flap reconstruction.
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Free Flap Reexploration: Indications, Treatment, and Outcomes in 1193 Free Flaps
Duc T. Bui, Peter G. Cordeiro, Qunying Hu et al. · Plastic & Reconstructive Surgery · 2007 · 540 citations
Medicine, Plastic Surgery, Surgery +17
Mark L. Urken, Daniel Buchbinder, Hubert Weinberg et al. · The Laryngoscope · 1991 · 347 citations