The Use of Intraoperative Fluorescent Angiography to Assess and Optimize Free Tissue Transfer in Traumatic Head and Neck Reconstruction

Abstract

Large composite tissue defects in the head and neck region secondary to trauma have long presented complex challenges to reconstructive surgeons. Refinements in microvascular free flaps have provided composite tissues for such traumatic defects, while also aiding in facial form and function for head and neck reconstructive surgery. Employment of such complex flap transfers as well as their multiple geometries for optimization of structural reconstruction creates its own set of difficulties. For those flaps utilizing large soft tissue envelopes, limitations in angiosome size or recruitment can contribute to the potential for partial and total flap loss, thus compromising the surgeon's reconstruction, and ultimately, negatively affecting the patient's overall outcome.