First Results of the Free Flap Transfer for the Head and Neck Reconstruction: The Public Hospital Experience

Abstract

ABSTRACTThe aim of the study is to assess our first results with the free flap transfer. Since October 2006 through April 2012, 58 operations were performed. The upper digestive tract was reconstructed in 46 cases, the soft tissues and skin of the head and neck region—in 12 cases. The primary plasty was performed in all but two cases. Eighteen first cases were performed with 2. 5 and 4x binocular loupes magnification only. The operating microscope was used in 40 cases. Fourty-two radial forearm fasciocutaneous flaps, five latissimus dorsi musculocutaneous flaps, nine anterolateral thigh flaps, one scapular osteocutaneous flap were used with the single case of the visceral flap— the jejunal flap. Death in early postoperative period occurred once. Complete flap loss occurred six times. Five radial and one latissimus dorsi free flaps were lost. The arterial thrombosis is considered as the primary cause of failure in one case, venous thrombosis—in two cases, postoperative infection—in one case with remaining two cases of the unknown primary cause of failure. There were three cases of the revision surgery with the attempts to reperform venous anastomosis, one of them was successful. The overall success rate in this series is 87.9%. Most of the failures occurred early in the series. The main cause of such a low rate of the success is a lack of experience. Even in a so small number of patients the results significantly improved from 72.2 to 94.4%.How to cite this articleKarpenko A, Roman L, Chumanikhina N, Kostyuk I, Sibgatullin R, Belova E, Evdokimova N, Dzhalilov First Results of the Free Flap Transfer for the Head and Neck Reconstruction: The Public Hospital Experience. Int J Head Neck Surg 2012;3(2):66-72.