Prospective Analysis of Outcomes and Complications of 300 Consecutive Microvascular Reconstructions

Abstract

Previous radiation therapy and surgery are positive predictors for wound complications after microvascular reconstruction. Diabetes may add further risk in this setting.

Free flap reconstruction in 1999 and 2009: Changing case characteristics and outcomes

“…Microvascular free tissue transfer is widely used for the reconstruction of head and neck defects, with excellent overall success rates reported in large series 1–4. Complex defects can be addressed in a single stage, and functional and cosmetic outcomes optimized with free flap reconstruction.…”

51 Microvascular and Regional Flaps in Head and Neck Reconstruction

“…42 Vessel thrombosis accounts for the majority of failures during the immediate postoperative period. Venous thrombosis is most common, accounting for 50% of flap failures.…”

Feasibility of Microvascular Head and Neck Reconstruction in the Setting of Calcified Arteriosclerosis of the Vascular Pedicle

“…Although the method was initially met with some hesitation owing to concerns regarding their perceived dependability, subsequent studies [1][2][3][4][5][6] have confirmed the unparalleled reliability and versatility of free flaps as a reconstructive technique. Reconstruction of defects following oncologic resection of head and neck cancer is one of the most common indications for free flap surgery.…”

“…Given the high reliability of free flaps for the head and neck, [1][2][3][4][5][6] this raises the question as to whether patients with peripheral vascular disease are a subset with potentially diminished free flap reliability. To the contrary of many earlier publications, in the current study, the incidence and pattern of postoperative complications and the risk of partial or total flap necrosis in patients with calcified atherosclerosis of the flap vascular pedicle was found to be similar to that which our group previously reported in 400 consecutive patients who underwent microvascular flap reconstruction of the head and neck.…”

“…1 With an increased understanding of flap physiology and refinement of surgical technique, microvascular free tissue transfer has demonstrated extraordinary consistency as a reconstructive modality, with success rates ranging from 96% to 99%. [1][2][3][4][5][6] As such, the reliability and versatility of the free flap reconstruction is unparalleled in head and neck surgery.…”