Free Tissue Transfer in Head and Neck Reconstruction: A Multidisciplinary 15-Year Experience

Author:

Papanikolaou Athanasios1,Guarino Laetitia1,Giger Roland2ORCID,Schaller Benoît3ORCID,Constantinescu Mihai14,Olariu Radu14ORCID,Lese Ioana14ORCID

Affiliation:

1. Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland

2. Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, 3008 Bern, Switzerland

3. Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland

4. Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland

Abstract

Background: Free tissue transfer is considered the gold standard in reconstruction of extensive defects in head and neck surgery. The aim of this 15-year retrospective study is to analyze the outcomes of free tissue transfers in the head and neck area in a tertiary referral university hospital. Materials and methods: A retrospective, single-center study of all patients undergoing free tissue transfers for head and neck reconstruction between 2006 and 2020 was performed. Patient demographics, comorbidities, flap characteristics, outcomes and complications were assessed. Results: A total of 353 free flaps were performed. The most common defect etiology was synchronous oncologic resection (74.2%). The majority of patients had at least one comorbidity (70.3%), with smoking recorded in 46.2% of the cases and alcohol consumption in 31.7%. The anterolateral thigh flap was the most commonly used flap (37.7%), followed by the osteoseptocutaneous fibula flap (26.9%). Our overall flap success rate was 97.7%, while the overall complication rate was 45.9%. Conclusions: Free tissue transfer in head and neck reconstruction is reliable. However, complication rates remain high due to the complexity of such cases and frequent presence of comorbidities. Nonetheless, when effectively managed within a multidisciplinary team, complications rarely jeopardize the overall reconstruction outcome.

Publisher

MDPI AG

Subject

General Medicine

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