Les échecs de la chirurgie reconstructrice cervicofaciale par lambeaux libres : facteurs favorisants et prise en charge

Management of Flap Failure After Head and Neck Reconstruction: A Systematic Review and Meta‐analysis

“…Thus, there may be a shift in prioritizing function and cosmesis, as operative morbidity from surgery may outweigh the original disease process. Data regarding management of free flap failure are limited to institutional retrospective cohort studies, 4,[9][10][11][12][13][14][15][16][17] case series, [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] and case reports. 38,39 Bender-Heine et al recently performed the first multi-institutional retrospective review on management of flap failures and designed various algorithms to manage flap failures.…”

Risk factors assessment in fibular free flap mandibular reconstruction

“…It could be explained by patients with vascular disease being generally old with a poor general condition [11]. Furthermore, a high ASA score was considered as a risk factor increasing the infection rate [12], as in our study.…”

“…After statistical analysis, neck dissection seems to be a significant RF (P = 0.017) for RS dehiscence, as described by David et al [12]. Moreover, ischemia time, infection rate, radiotherapy and alcohol use influenced significantly the RS dehiscence rate.…”

“…Radiation therapy can damage small vessels and potentially affect microvascular anastomoses [11]. After statistical analysis, preoperative radiotherapy influenced significantly (P = 0.034) the rate of flap necrosis, as in the literature [12]. However, other authors demonstrated that irradiation does not compromise the RS healing and the flap viability [1,6].…”

Oral and Oropharyngeal Reconstruction with a Free Flap

“…The reconstructive goals for oral and oropharyngeal defects are to restore the anatomy, to maintain continuity of the intraoral surface and oropharynx, to protect vital structures such as carotid arteries, to cover exposed portions of internal organs in preparation for adjuvant radiation, and to preserve complex functions of the oral cavity and oropharynx [ 12 13 14 ]. With the development of microsurgical techniques, free flaps has become the most popular choice for reconstruction of oral and oropharyngeal defects in most hospitals, with flap survival rates reported to be as high as 95% [ 15 16 17 ]. Because the important functions of oral cavity and oropharynx, the purpose of reconstruction has focused on preserving such functions and helping patients to achieve a normal life ( Table 1 ) [ 18 19 20 21 ].…”