Multiple sequential free flap reconstructions of the head and neck

• Verfasst von: Moratin, Julius [VerfasserIn]
• Verfasst von: Horn, Dominik [VerfasserIn]
• Verfasst von: Heinemann, Maleen [VerfasserIn]
• Verfasst von: Semmelmayer, Karl [VerfasserIn]
• Verfasst von: Mrosek, Jan Bernd [VerfasserIn]
• Verfasst von: Ristow, Oliver [VerfasserIn]
• Verfasst von: Engel, Michael [VerfasserIn]
• Verfasst von: Freudlsperger, Christian [VerfasserIn]
• Verfasst von: Freier, Kolja [VerfasserIn]
• Verfasst von: Hoffmann, Jürgen [VerfasserIn]
• Titel: Multiple sequential free flap reconstructions of the head and neck
• Titelzusatz: a single-center experience
• Verf.angabe: Julius Moratin, Dominik Horn, Maleen Heinemann, Karl Metzger, Jan Mrosek, Oliver Ristow, Michael Engel, Christian Freudlsperger, Kolja Freier, Jürgen Hoffmann
• E-Jahr: 2021
• Jahr: November 2021
• Umfang: 9 S.
• Fussnoten: Gesehen am 03.12.2021
• Titel Quelle: Enthalten in: Plastic and reconstructive surgery
• Ort Quelle: Philadelphia, Pa. : Lippincott Williams & Wilkins, 1946
• Jahr Quelle: 2021
• Band/Heft Quelle: 148(2021), 5, Artikel-ID 791e-799e
• ISSN Quelle: 1529-4242
• DOI: doi:10.1097/PRS.0000000000008432
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1780200358

Abstract

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: - 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: - 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: - 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: - Therapeutic, IV.