Microvascular free flaps in head and neck surgery: complications and outcome of 1000 flaps.
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Microvascular free flaps in head and neck surgery: complications and outcome of 1000 flaps. / Pohlenz, Philipp; Klatt, Jan; Schön, Gerhard; Blessmann, Marco; Li, L; Schmelzle, Rainer.
in: INT J ORAL MAX SURG, Jahrgang 41, Nr. 6, 6, 2012, S. 739-743.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Microvascular free flaps in head and neck surgery: complications and outcome of 1000 flaps.
AU - Pohlenz, Philipp
AU - Klatt, Jan
AU - Schön, Gerhard
AU - Blessmann, Marco
AU - Li, L
AU - Schmelzle, Rainer
PY - 2012
Y1 - 2012
N2 - This study analyzed the surgical outcome and complications of 1000 microvascular free flaps performed at the authors' institution in Germany, between 1987 and 2010. 972 patients underwent reconstruction with 1000 flaps: 28% latissimus dorsi flaps, 27% radial forearm flaps, 20% iliac crest flaps, 12% fibula flaps, 6% jejunal flaps, 2% anterolateral thigh flaps, and 5% other flaps. 130 failures (7.6%) were encountered, including 58 complete flap failures (44.6%) and 72 partial free-flap failures (55.4%). This study confirms that free flaps are extremely reliable in achieving successful reconstruction of the head and neck, but it is essential that complications be recognized and addressed early in their course to prevent or minimize devastating consequences. Owing to the large number of possible errors in flap transplantation, microsurgeons should always check everything for themselves. The on-duty doctors and nursing staff should not be trusted blindly. Venous thrombosis and cervical haematoma are the most common complications at the recipient site and are mainly responsible for flap failure, while complications occurring at the donor site may result from dehiscence and graft necrosis. When a compromised flap is identified, surgical re-exploration should not be deferred.
AB - This study analyzed the surgical outcome and complications of 1000 microvascular free flaps performed at the authors' institution in Germany, between 1987 and 2010. 972 patients underwent reconstruction with 1000 flaps: 28% latissimus dorsi flaps, 27% radial forearm flaps, 20% iliac crest flaps, 12% fibula flaps, 6% jejunal flaps, 2% anterolateral thigh flaps, and 5% other flaps. 130 failures (7.6%) were encountered, including 58 complete flap failures (44.6%) and 72 partial free-flap failures (55.4%). This study confirms that free flaps are extremely reliable in achieving successful reconstruction of the head and neck, but it is essential that complications be recognized and addressed early in their course to prevent or minimize devastating consequences. Owing to the large number of possible errors in flap transplantation, microsurgeons should always check everything for themselves. The on-duty doctors and nursing staff should not be trusted blindly. Venous thrombosis and cervical haematoma are the most common complications at the recipient site and are mainly responsible for flap failure, while complications occurring at the donor site may result from dehiscence and graft necrosis. When a compromised flap is identified, surgical re-exploration should not be deferred.
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Aged, 80 and over
KW - Adolescent
KW - Young Adult
KW - Treatment Outcome
KW - Child
KW - Follow-Up Studies
KW - Child, Preschool
KW - Retrospective Studies
KW - Reoperation
KW - Graft Survival
KW - Reconstructive Surgical Procedures/methods
KW - Necrosis
KW - Postoperative Hemorrhage/etiology
KW - Bone Transplantation
KW - Postoperative Complications
KW - Free Tissue Flaps/blood supply
KW - Head and Neck Neoplasms/surgery
KW - Hematoma/etiology
KW - Muscle, Skeletal/transplantation
KW - Skin Transplantation
KW - Surgical Wound Dehiscence/etiology
KW - Thrombosis/etiology
KW - Transplant Donor Site/pathology
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Aged, 80 and over
KW - Adolescent
KW - Young Adult
KW - Treatment Outcome
KW - Child
KW - Follow-Up Studies
KW - Child, Preschool
KW - Retrospective Studies
KW - Reoperation
KW - Graft Survival
KW - Reconstructive Surgical Procedures/methods
KW - Necrosis
KW - Postoperative Hemorrhage/etiology
KW - Bone Transplantation
KW - Postoperative Complications
KW - Free Tissue Flaps/blood supply
KW - Head and Neck Neoplasms/surgery
KW - Hematoma/etiology
KW - Muscle, Skeletal/transplantation
KW - Skin Transplantation
KW - Surgical Wound Dehiscence/etiology
KW - Thrombosis/etiology
KW - Transplant Donor Site/pathology
M3 - SCORING: Journal article
VL - 41
SP - 739
EP - 743
JO - INT J ORAL MAX SURG
JF - INT J ORAL MAX SURG
SN - 0901-5027
IS - 6
M1 - 6
ER -