Microvascular free flaps in head and neck surgery: complications and outcome of 1000 flaps.

Philipp Pohlenz; Jan Klatt; Gerhard Schön; Marco Blessmann; L Li; Rainer Schmelzle

Microvascular free flaps in head and neck surgery: complications and outcome of 1000 flaps.

Standard

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, Vol. 41, No. 6, 6, 2012, p. 739-743.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Pohlenz, P, Klatt, J, Schön, G , Blessmann, M, Li, L & Schmelzle, R 2012, 'Microvascular free flaps in head and neck surgery: complications and outcome of 1000 flaps.', INT J ORAL MAX SURG, vol. 41, no. 6, 6, pp. 739-743. <http://www.ncbi.nlm.nih.gov/pubmed/22424757?dopt=Citation>

APA

Pohlenz, P., Klatt, J., Schön, G., Blessmann, M., Li, L., & Schmelzle, R. (2012). Microvascular free flaps in head and neck surgery: complications and outcome of 1000 flaps. INT J ORAL MAX SURG, 41(6), 739-743. [6]. http://www.ncbi.nlm.nih.gov/pubmed/22424757?dopt=Citation

Vancouver

Pohlenz P, Klatt J, Schön G , Blessmann M, Li L, Schmelzle R. Microvascular free flaps in head and neck surgery: complications and outcome of 1000 flaps. INT J ORAL MAX SURG. 2012;41(6):739-743. 6.

Bibtex

@article{87711b241fca4d94b08844a483872f1b,

title = "Microvascular free flaps in head and neck surgery: complications and outcome of 1000 flaps.",

abstract = "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.",

keywords = "Adult, Humans, Male, Aged, Female, Middle Aged, Aged, 80 and over, Adolescent, Young Adult, Treatment Outcome, Child, Follow-Up Studies, Child, Preschool, Retrospective Studies, Reoperation, Graft Survival, Reconstructive Surgical Procedures/*methods, Necrosis, Postoperative Hemorrhage/etiology, Bone Transplantation, *Postoperative Complications, *Free Tissue Flaps/blood supply, Head and Neck Neoplasms/*surgery, Hematoma/etiology, Muscle, Skeletal/transplantation, Skin Transplantation, Surgical Wound Dehiscence/etiology, Thrombosis/etiology, Transplant Donor Site/pathology, Adult, Humans, Male, Aged, Female, Middle Aged, Aged, 80 and over, Adolescent, Young Adult, Treatment Outcome, Child, Follow-Up Studies, Child, Preschool, Retrospective Studies, Reoperation, Graft Survival, Reconstructive Surgical Procedures/*methods, Necrosis, Postoperative Hemorrhage/etiology, Bone Transplantation, *Postoperative Complications, *Free Tissue Flaps/blood supply, Head and Neck Neoplasms/*surgery, Hematoma/etiology, Muscle, Skeletal/transplantation, Skin Transplantation, Surgical Wound Dehiscence/etiology, Thrombosis/etiology, Transplant Donor Site/pathology",

author = "Philipp Pohlenz and Jan Klatt and Gerhard Sch{\"o}n and Marco Blessmann and L Li and Rainer Schmelzle",

year = "2012",

language = "English",

volume = "41",

pages = "739--743",

journal = "INT J ORAL MAX SURG",

issn = "0901-5027",

publisher = "Churchill Livingstone",

number = "6",

}

RIS

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