Multiple Sequential Free Flap Reconstructions of the Head and Neck: A Single-Center Experience.
Adolescent
Adult
Aged
Aged, 80 and over
Feasibility Studies
Female
Free Tissue Flaps
/ transplantation
Head
/ surgery
Head and Neck Neoplasms
/ psychology
Humans
Male
Middle Aged
Neck
/ surgery
Neoplasm Recurrence, Local
/ psychology
Quality of Life
Plastic Surgery Procedures
/ methods
Reoperation
/ methods
Retrospective Studies
Surgical Wound
/ etiology
Treatment Outcome
Young Adult
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
01 Nov 2021
01 Nov 2021
Historique:
pubmed:
30
9
2021
medline:
19
1
2022
entrez:
29
9
2021
Statut:
ppublish
Résumé
Free flap reconstruction is the standard of care in extensive defects of the head and neck area, and although most patients may be treated sufficiently with one flap, recurrence of a malignant tumor or failure of a previous reconstruction may make the use of a second (or more) flap necessary. The aim of this study was to evaluate the indications and success rates of multiple consecutive reconstructive procedures in a large cohort of patients. Nine hundred ninety-six free flap reconstructions were retrospectively analyzed and cases of sequential reconstructions in the same patient were identified. Indications, success rates, perioperative procedures, and frequently used flaps were evaluated. Two hundred twenty cases of sequential microvascular reconstructions were identified, ranging from two to six flaps per patient. The overall flap success rate was 89.1 percent. A history of diabetes was identified as a risk factor for flap failure (p = 0.029). There was no association of flap loss with the number of reconstructive procedures per patient. The use of several free flaps in the same patient is a feasible option for patients suffering from recurrent tumors or to improve quality of life by a secondary reconstruction. A salvage free flap transfer to replace a lost transplant exhibits good success rates. Therapeutic, IV.
Sections du résumé
BACKGROUND
BACKGROUND
Free flap reconstruction is the standard of care in extensive defects of the head and neck area, and although most patients may be treated sufficiently with one flap, recurrence of a malignant tumor or failure of a previous reconstruction may make the use of a second (or more) flap necessary. The aim of this study was to evaluate the indications and success rates of multiple consecutive reconstructive procedures in a large cohort of patients.
METHODS
METHODS
Nine hundred ninety-six free flap reconstructions were retrospectively analyzed and cases of sequential reconstructions in the same patient were identified. Indications, success rates, perioperative procedures, and frequently used flaps were evaluated.
RESULTS
RESULTS
Two hundred twenty cases of sequential microvascular reconstructions were identified, ranging from two to six flaps per patient. The overall flap success rate was 89.1 percent. A history of diabetes was identified as a risk factor for flap failure (p = 0.029). There was no association of flap loss with the number of reconstructive procedures per patient.
CONCLUSIONS
CONCLUSIONS
The use of several free flaps in the same patient is a feasible option for patients suffering from recurrent tumors or to improve quality of life by a secondary reconstruction. A salvage free flap transfer to replace a lost transplant exhibits good success rates.
CLINICAL QUESTION/LEVEL OF EVIDENCE
METHODS
Therapeutic, IV.
Identifiants
pubmed: 34586092
doi: 10.1097/PRS.0000000000008432
pii: 00006534-202111000-00032
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
791e-799eInformations de copyright
Copyright © 2021 by the American Society of Plastic Surgeons.
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