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Multiple sequential free flap reconstructions of the head and neck: a single-center experience

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)...

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Main Authors: Moratin, Julius (Author) , Horn, Dominik (Author) , Heinemann, Maleen (Author) , Semmelmayer, Karl (Author) , Mrosek, Jan Bernd (Author) , Ristow, Oliver (Author) , Engel, Michael (Author) , Freudlsperger, Christian (Author) , Freier, Kolja (Author) , Hoffmann, Jürgen (Author)
Format: Article (Journal)
Language:English
Published: November 2021
In: Plastic and reconstructive surgery
Year: 2021, Volume: 148, Issue: 5
ISSN:1529-4242
DOI:10.1097/PRS.0000000000008432
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/PRS.0000000000008432
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/plasreconsurg/Fulltext/2021/11000/Multiple_Sequential_Free_Flap_Reconstructions_of.32.aspx
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Author Notes:Julius Moratin, Dominik Horn, Maleen Heinemann, Karl Metzger, Jan Mrosek, Oliver Ristow, Michael Engel, Christian Freudlsperger, Kolja Freier, Jürgen Hoffmann
Description
Summary: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.
Item Description:Gesehen am 03.12.2021
Physical Description:Online Resource
ISSN:1529-4242
DOI:10.1097/PRS.0000000000008432

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