Analysis of Flap Failures in Microvascular Head and Neck Reconstructions: 11-Year Single-Center Results
Background Free flap reconstruction is the gold standard in head and neck reconstructions. The current article analyzes failed free flaps in the head and neck region during an 11-year period in a single center aiming to discover factors that could be influenced in order to reduce the risk for flap f...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Georg Thieme Verlag KG
2023-01-01
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| Series: | Journal of Reconstructive Microsurgery Open |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-2003-9976 |
| _version_ | 1797900886944514048 |
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| author | Daria Jokinen Marika Kuuskeri Mika Helminen Minna Kääriäinen |
| author_facet | Daria Jokinen Marika Kuuskeri Mika Helminen Minna Kääriäinen |
| author_sort | Daria Jokinen |
| collection | DOAJ |
| description | Background Free flap reconstruction is the gold standard in head and neck reconstructions. The current article analyzes failed free flaps in the head and neck region during an 11-year period in a single center aiming to discover factors that could be influenced in order to reduce the risk for flap failure.
Methods During the 11-year study period, 336 patients underwent free flap reconstruction at Tampere University Hospital, Tampere, Finland. The patients' average age was 62 years (range 14–92 years). Note that 201 (61.5%) of the patients were women and 135 (38.5%) men. Medical records were reviewed for demographics, comorbidities, neoadjuvant and adjuvant therapies, free flap type, area of reconstruction, and intraoperative and postoperative complications. Statistical analyses were performed.
Results Ten (3%) of the 336 free flaps failed. Patients' age, comorbidities, smoking, dosage of anticoagulation, free flap type, or the location of the defect did not influence the risk of flap failure. All lost flaps were postoperatively followed by clinical monitoring only. In contrast, 89% of all flaps had both Licox (Integra LifeSciences Corp, NJ) and clinical follow-up postoperatively. In six (60%) of the failed cases, a second free flap surgery was performed as a salvage procedure, with a survival rate of 83.3%.
Conclusion Our free flap success rate of 97% is in accordance with that of other centers that perform head and neck reconstructions. According to our findings, free flap reconstructions can be successfully performed on elderly patients and patients with comorbidities. Smoking did not increase the flap loss rate. We encourage the use of other methods in addition to clinical monitoring to follow the flaps after head and neck free flap reconstructions. All flap types used have high success rates, and reconstruction can be conducted with the most suitable flaps for the demands of the defect. |
| first_indexed | 2024-04-10T08:53:08Z |
| format | Article |
| id | doaj.art-204a9d00d05c46abb0af456cd3c417b3 |
| institution | Directory Open Access Journal |
| issn | 2377-0813 2377-0821 |
| language | English |
| last_indexed | 2024-04-10T08:53:08Z |
| publishDate | 2023-01-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Journal of Reconstructive Microsurgery Open |
| spelling | doaj.art-204a9d00d05c46abb0af456cd3c417b32023-02-22T00:01:55ZengGeorg Thieme Verlag KGJournal of Reconstructive Microsurgery Open2377-08132377-08212023-01-010801e18e2210.1055/a-2003-9976Analysis of Flap Failures in Microvascular Head and Neck Reconstructions: 11-Year Single-Center ResultsDaria Jokinen0Marika Kuuskeri1Mika Helminen2Minna Kääriäinen3Department of Plastic Surgery, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, FinlandDepartment of Plastic Surgery, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, FinlandTays Research Services, Tampere University Hospital and Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, FinlandDepartment of Plastic Surgery, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, FinlandBackground Free flap reconstruction is the gold standard in head and neck reconstructions. The current article analyzes failed free flaps in the head and neck region during an 11-year period in a single center aiming to discover factors that could be influenced in order to reduce the risk for flap failure. Methods During the 11-year study period, 336 patients underwent free flap reconstruction at Tampere University Hospital, Tampere, Finland. The patients' average age was 62 years (range 14–92 years). Note that 201 (61.5%) of the patients were women and 135 (38.5%) men. Medical records were reviewed for demographics, comorbidities, neoadjuvant and adjuvant therapies, free flap type, area of reconstruction, and intraoperative and postoperative complications. Statistical analyses were performed. Results Ten (3%) of the 336 free flaps failed. Patients' age, comorbidities, smoking, dosage of anticoagulation, free flap type, or the location of the defect did not influence the risk of flap failure. All lost flaps were postoperatively followed by clinical monitoring only. In contrast, 89% of all flaps had both Licox (Integra LifeSciences Corp, NJ) and clinical follow-up postoperatively. In six (60%) of the failed cases, a second free flap surgery was performed as a salvage procedure, with a survival rate of 83.3%. Conclusion Our free flap success rate of 97% is in accordance with that of other centers that perform head and neck reconstructions. According to our findings, free flap reconstructions can be successfully performed on elderly patients and patients with comorbidities. Smoking did not increase the flap loss rate. We encourage the use of other methods in addition to clinical monitoring to follow the flaps after head and neck free flap reconstructions. All flap types used have high success rates, and reconstruction can be conducted with the most suitable flaps for the demands of the defect.http://www.thieme-connect.de/DOI/DOI?10.1055/a-2003-9976head and neck reconstructionfree flapflap losscomplicationsflap monitoring |
| spellingShingle | Daria Jokinen Marika Kuuskeri Mika Helminen Minna Kääriäinen Analysis of Flap Failures in Microvascular Head and Neck Reconstructions: 11-Year Single-Center Results Journal of Reconstructive Microsurgery Open head and neck reconstruction free flap flap loss complications flap monitoring |
| title | Analysis of Flap Failures in Microvascular Head and Neck Reconstructions: 11-Year Single-Center Results |
| title_full | Analysis of Flap Failures in Microvascular Head and Neck Reconstructions: 11-Year Single-Center Results |
| title_fullStr | Analysis of Flap Failures in Microvascular Head and Neck Reconstructions: 11-Year Single-Center Results |
| title_full_unstemmed | Analysis of Flap Failures in Microvascular Head and Neck Reconstructions: 11-Year Single-Center Results |
| title_short | Analysis of Flap Failures in Microvascular Head and Neck Reconstructions: 11-Year Single-Center Results |
| title_sort | analysis of flap failures in microvascular head and neck reconstructions 11 year single center results |
| topic | head and neck reconstruction free flap flap loss complications flap monitoring |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-2003-9976 |
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