Issue N# 1 - 2016
HEAD AND NECK CARCINOLOGY
Management of free-flap failure in head and neck reconstructive surgery
Authors : Fernandez J, Culié D, Poissonnet G, Berguiga R, Riss JC, Hechema R, Dassonville O, Bozec A. (Nice)
Ref. : Rev Laryngol Otol Rhinol. 2016;137,1:11-16.
Article published in french
Downloadable PDF document french
Objective: The aim of this study was to analyze the management of free-flap failures in head and neck reconstructive surgery. Material and methods: All patients who experienced a free-flap failure in head and neck reconstructive surgery in our institution between 2000 and 2014 were included in this retrospective study. Results: A total of 51 free-flap failures (among 547 free flaps, 9.3%) were found during this period. They were 34 men and 17 women (mean age: 63.9 years). In 3 cases, a cause of failure was precisely identified (arterial spasm, protein S deficiency and atherosclerotic occlusion of peroneal artery). A second free flap was performed in 19 cases (37.3%) and a thoracic pedicled musculocutaneous flap was performed in 26 cases. A second free flap was performed for velar reconstruction in 8/8 cases, for mandibular symphyseal reconstruction in 4/5 cases and for pharyngeal reconstruction after circular total pharyngolaryngectomy in 4/7 cases. There were 2 failures among the 19 free flaps used for secondary reconstruction (10.5%). Conclusion: After a free flap failure, the choice of the secondary method of reconstruction depends on the identification of the causes of free-flap failure and their reversibility, the local and general conditions of the patient, as well as the predictable benefit of the use of a second free flap.
Price : 14.00 €