[Postoperative vessel thrombosis and its management after free flap transfers in head and neck region].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi

Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, Beijing 100081, China.

Published: June 2005

Objective: To analyze the rate of postoperative vessel thrombosis and its management after free tissue transfers in head and neck region.

Methods: Eight hundred and forty-nine consecutive free flap transfers were performed from May 1999 to September 2004. Among them, the flaps with postoperative vessel thrombosis were selected and reviewed. Data concerning each case included time of vessel thrombosis, kind of thrombosis, time of emergent exploration, and salvage of free flaps.

Results: Among the 849 free flaps, postoperative vessel thrombosis occurred in 28 free flaps, between 8 to 120 hours after operation. There were 5 arterial thrombosis, and 23 venous thrombosis. Thirteen flaps were salvaged after emergent exploration, and 15 flaps were lost. The rate of postoperative vessel thrombosis was 3.3% in this group, the salvage rate of flap was 46.4%, and the overall successful rate was 98.2%.

Conclusion: Clinical monitoring after free flap transfer in head and neck region is very important and effective. In case of vessel thrombosis, emergent exploration is the only effective way to salvage the flap.

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