Objectives: To describe the experience of two tertiary academic centers with multiple, simultaneous free flaps for complex head and neck defect reconstruction.
Methods: Patients undergoing multiple, simultaneous free flaps from 2017 to 2022 were retrospectively reviewed.
Results: Seventy-one patients (64.8% male, median age 61 years) were identified and underwent 143 free flaps. The leading surgical indication was squamous cell carcinoma (n = 48, 67.6%). Defect sites included oral cavity, maxilla, pharynx, parotid, skull base, and scalp. The most common free flap combinations were fibula (FFF) with anterolateral thigh flap (n = 33, 46.5%), radial forearm (RFFF) with scapula (n = 11, 15.5%), and RFFF with FFF (n = 10, 14.1%). Median operative time was 12 h. Median length of hospitalization was 10 days. At last follow-up (median 6 months), 141 flaps (98.6%) survived without partial nor complete flap failure.
Conclusion: Multiple, simultaneous free flaps are a rare, yet reliable option for head and neck reconstruction in select patients with defects involving several tissue types, multiple functional areas, or large volumes.
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http://dx.doi.org/10.1016/j.oraloncology.2022.106269 | DOI Listing |
Microsurgery
February 2025
Plastic and Reconstructive Surgery, Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy.
Background: Scalp reconstruction is a challenging field for plastic surgeons. In case of large or complex defects, microsurgical-free flaps are usually required. Reconstructive failure can result in high morbidity and in some cases be life-threatening.
View Article and Find Full Text PDFJ Craniomaxillofac Surg
January 2025
Department of Oral- and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, Germany.
Postoperative bone resorption within the first year after a free fibular flap is a common problem and poses major challenges for subsequent therapies. Due to the concerns of increased bone resorption, short segments in particular, i.e.
View Article and Find Full Text PDFJ Plast Surg Hand Surg
January 2025
Department of Plastic and Reconstructive Surgery, Skåne University Hospital, Malmö, Sweden.
Introduction: Health-related quality of life (HR-QoL) outcomes following maxillary reconstruction with the scapular osseous free flap (SOFF) are lacking. Material and Methods: To determine these outcomes, a study of patients who completed maxillary reconstruction with flap survival of the SOFF between 2016 and 2023 was conducted, using Face-Q Head and Neck Cancer Module (FACE-Q).
Results: Eligible patients had at least six months of follow-up.
Microsurgery
January 2025
Plastic, Reconstructive, and Aesthetic Surgery Unit, Nantes University Hospital, Nantes, France.
Introduction: Reconstructing large bone defects for lower limb salvage in the pediatric population remains challenging due to complex oncological or septic issues, limited surgical options, and lengthy procedures prone to complications. The vascularized double-barreled fibula free flap is pivotal for reconstructing large bones. In this article, we report our experience with this technique in the surgical management of pediatric tibial bone defects.
View Article and Find Full Text PDFMicrosurgery
January 2025
Service de Chirurgie Plastique et Reconstructrice, Hôpital européen Georges-Pompidou, Paris, France.
Objective: The optimal method for maintaining intraoperative blood pressure during microsurgical procedures remains controversial. While intravenous fluid administration is essential, overfilling can lead to complications. Vasopressor agents are used cautiously due to their vasoconstrictive effects, which could potentially lead to flap failure.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!