Microvascular free flaps in head and neck surgery: complications and outcome of 1000 flaps.

Link:
Autor/in:
Erscheinungsjahr:
2012
Medientyp:
Text
Schlagworte:
  • Adult
  • Humans
  • Male
  • Aged
  • Female
  • Middle Aged
  • Aged, 80 and over
  • Adolescent
  • Young Adult
  • Treatment Outcome
  • Child
  • Follow-Up Studies
  • Child, Preschool
  • Retrospective Studies
  • Reoperation
  • Graft Survival
  • Reconstructive Surgical Procedures/*methods
  • Necrosis
  • Postoperative Hemorrhage/etiology
  • Bone Transplantation
  • *Postoperative Complications
  • *Free Tissue Flaps/blood supply
  • Head and Neck Neoplasms/*surgery
  • Hematoma/etiology
  • Muscle, Skeletal/transplantation
  • Skin Transplantation
  • Surgical Wound Dehiscence/etiology
  • Thrombosis/etiology
  • Transplant Donor Site/pathology
  • Adult
  • Humans
  • Male
  • Aged
  • Female
  • Middle Aged
  • Aged, 80 and over
  • Adolescent
  • Young Adult
  • Treatment Outcome
  • Child
  • Follow-Up Studies
  • Child, Preschool
  • Retrospective Studies
  • Reoperation
  • Graft Survival
  • Reconstructive Surgical Procedures/*methods
  • Necrosis
  • Postoperative Hemorrhage/etiology
  • Bone Transplantation
  • *Postoperative Complications
  • *Free Tissue Flaps/blood supply
  • Head and Neck Neoplasms/*surgery
  • Hematoma/etiology
  • Muscle, Skeletal/transplantation
  • Skin Transplantation
  • Surgical Wound Dehiscence/etiology
  • Thrombosis/etiology
  • Transplant Donor Site/pathology
Beschreibung:
  • This study analyzed the surgical outcome and complications of 1000 microvascular free flaps performed at the authors' institution in Germany, between 1987 and 2010. 972 patients underwent reconstruction with 1000 flaps: 28% latissimus dorsi flaps, 27% radial forearm flaps, 20% iliac crest flaps, 12% fibula flaps, 6% jejunal flaps, 2% anterolateral thigh flaps, and 5% other flaps. 130 failures (7.6%) were encountered, including 58 complete flap failures (44.6%) and 72 partial free-flap failures (55.4%). This study confirms that free flaps are extremely reliable in achieving successful reconstruction of the head and neck, but it is essential that complications be recognized and addressed early in their course to prevent or minimize devastating consequences. Owing to the large number of possible errors in flap transplantation, microsurgeons should always check everything for themselves. The on-duty doctors and nursing staff should not be trusted blindly. Venous thrombosis and cervical haematoma are the most common complications at the recipient site and are mainly responsible for flap failure, while complications occurring at the donor site may result from dehiscence and graft necrosis. When a compromised flap is identified, surgical re-exploration should not be deferred.
  • This study analyzed the surgical outcome and complications of 1000 microvascular free flaps performed at the authors' institution in Germany, between 1987 and 2010. 972 patients underwent reconstruction with 1000 flaps: 28% latissimus dorsi flaps, 27% radial forearm flaps, 20% iliac crest flaps, 12% fibula flaps, 6% jejunal flaps, 2% anterolateral thigh flaps, and 5% other flaps. 130 failures (7.6%) were encountered, including 58 complete flap failures (44.6%) and 72 partial free-flap failures (55.4%). This study confirms that free flaps are extremely reliable in achieving successful reconstruction of the head and neck, but it is essential that complications be recognized and addressed early in their course to prevent or minimize devastating consequences. Owing to the large number of possible errors in flap transplantation, microsurgeons should always check everything for themselves. The on-duty doctors and nursing staff should not be trusted blindly. Venous thrombosis and cervical haematoma are the most common complications at the recipient site and are mainly responsible for flap failure, while complications occurring at the donor site may result from dehiscence and graft necrosis. When a compromised flap is identified, surgical re-exploration should not be deferred.
Lizenz:
  • info:eu-repo/semantics/restrictedAccess
Quellsystem:
Forschungsinformationssystem des UKE

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oai:pure.atira.dk:publications/87711b24-1fca-4d94-b088-44a483872f1b