Analysis of 180 Head and Neck Reconstructional Cases with Free Flap Transfer

ABSTRACT

Microvascular surgery now plays an increasingly important role in head and neck reconstruction. When compared to local or regional flaps, free flaps are more effective in complex or extensive defects, have better blood supply and are not restricted by the territory of the pedicle. Recently, not only coverage of the defect but restoration of both function and aesthetics with rapid recovery and minimal morbidity have become the interest of many surgeons. A retrospective study was conducted including 180 microvascular free tissue transfer for reconstruction of surgical defects in the head and neck region by the plastic & reconstructive surgery department at Yonsei Medical Center. The flap survival rate was 95.5 percent. Complications developed in 46 cases(25.5%). In our study, the radial forearm free flap was most commonly used(75%) and the primary location of tumors were the tonsils(18.3%), oral tongue(17.8%) and pyriform sinus (17.2%). Analysis in this study shows obesity as the only independent factor for development of complications while the number of risk factors of the patient were associated with an increased risk. With our analysis, many factors were found not to have a significant effect on flap outcome, including flap transfer in smokers, diabetics and preoperative radiation status. In our opinion, accumulation effect of the risk factors seems to be more important in determining the flap outcome and complications than that of independent risk factors.