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Analytic Review of 2372 Free Flap Transfers for Head and Neck Reconstruction Following Cancer Resection
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2003
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Surgical OncologyLimb ReconstructionMinimally Invasive ProcedureSurgeryOrthopaedic SurgeryFlap PhysiologyNeuro-oncologySoft Tissue SurgeryFree Flap TransfersVascularized Bone GraftMaxillofacial SurgeryNeck OncologyCancer ResectionFlap NecrosisFree FlapsRadiologyHealth SciencesMedicineHead And Neck SurgeryCancer AblationReconstructive SurgeryHead And Neck CancerWound HealingCraniofacial SurgerySoft Tissue ReconstructionOncologyAnalytic ReviewPlastic Surgery
Microvascular free tissue transfer is now the standard approach for reconstructing post‑oncologic defects in the head and neck. Since 1977, the authors have performed 2372 free flaps in 2301 patients over more than 23 years. In this series, rectus abdominis, jejunum, and forearm flaps were most common, with total and partial necrosis rates of 4.2 % and 2.5 %, a higher survival for immediate reconstructions, and the authors conclude these flaps provide lower necrosis rates than other options.
Microvascular free tissue transfer has gained world-wide acceptance as a means of reconstructing post-oncologic surgical defects in the head and neck region. Since 1977, the authors have introduced this reconstructive procedure to head and neck reconstruction after cancer ablation, and a total of 2372 free flaps were transferred in 2301 patients during a period of over 23 years. The most frequently used flap was the rectus abdominis flap (784 flaps: 33.1 percent), followed by the jejunum (644 flaps: 27.2 percent) and the forearm flap (384 flaps: 16.2 percent). In the reported series, total and partial flap necrosis accounted for 4.2 percent and 2.5 percent of cases, respectively. There was a significant statistical difference ( p < 0.05) in complete flap survival rate between immediate and secondary reconstruction cases. The authors believe that the above-mentioned three flaps have been a major part of the armamentarium for head and neck reconstruction because of a lower rate of flap necrosis, compared to other flaps.