Early Experience of Free Flap Reconstruction for Head and Neck Defect

Ahn, Soon Hyun

Abstract

BACKGROUND AND OBJECTIVES: Due to the complexity of the anatomy and function of head and neck region, the reconstruction of ablative defect in this area was always challenging. Also the increasing interest in quality of life makes the role of free flap more important for good functional result. The aim of this study is to review the result of early experience with free flap reconstruction and to show the importance of appropriate reoperation of compromised flaps.
SUBJECTS AND METHOD
The medical records of patients who underwent free flap reconstruction from 2004 to 2007 were reviewed retrospectively. There were 37 patients with the average age of 58 years. The applied type of flap, primary tumor required for free flap and result for flap reoperation were analyzed.
RESULTS
The overall success rate was 92% with 3 failure cases. Less experience and radical neck dissection sacrificing internal jugular vein were significant risk factor for flap failure. Reoperation due to compromised circulation of flap was performed in 8 patients (21.6%) and seven out of eight flap could be salvaged successfully (87.5%). The average time interval between detection of flap discoloration and reoperation was 54 min.
CONCLUSION
The free flap technique is safe but needs some learning period and careful monitoring. Early intervention is important for saving the free flap and lowering the failure rate.