An Analysis of Outcome and Complications of Microvascular Free Flap Head and Neck Reconstruction

Abstract

Background: Microvascular free ap transfers have become a preferred reconstructive technique; however, rare complica-tions may still prove devastating. Aim: The objective of this study was to evaluate the clinical outcomes in Head and neck cancer patients undergoing different microvascular free ap reconstructions . Materials and Methods: his study analyzed the surgical out-come and complications of 200 microvascular free aps head and neck reconstruction. In most cases, after resection of the malignant tumor, reconstruction was undertaken . Four types of free ap were performed as follows: Anterolateral thigh (80%), radial forearm (15%), bula (4%), and jejunum (1%). The most commonly used as recipient vessels for anastomosis were superior thyroid artery and the external jugular vein. The incidence of perioperative complications and Patient-related characteristics (age, sex, diagnosis, comorbidity, level, tumor stage, defect site, primary versus secondary reconstruction, and history of surgery, radiation therapy, or chemotherapy) were recorded prospectively. Observations and results: Emergency surgical re-exploration was required in nine patients and the overall ap success rate was 95.3%. Venous thrombosis was the most common cause for re-exploration. Other complications included wound infection (12.5%), wound dehiscence (15%), partial ap necrosis (2.5%), stula formation (9.5%), and bleeding (1.5%). Recipient and donor site morbidity was limited and considered acceptable. Conclusions: Micro surgical free ap is shown to be a valuable and reliable method in head and neck surgery which can be used effectively and safely with minimal morbidity in selected patients. When performed by skilled surgeon, reconstruction can be performed with acceptable outcomes and early re-exploration should be the rst choice for the management of vascular compromised aps.