Microsurgical Free Flap Reconstructions of Head and Neck Region in 406 Cases: A 13-Year Experience

Gerressen, Marcus; Pastaschek, Claudia Inge; Riediger, D; Hilgers, Ralf-Dieter; Hölzle, Frank; Noroozi, Nelson; Ghassemi, Alireza

doi:10.1016/j.joms.2012.07.002

Cited by 63 publications

(49 citation statements)

References 38 publications

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“…Outcome data on total flap failure, thrombosis, and hematoma formation were extracted and analyzed for comparison against all anticoagulation regimens. One study was included in the systematic review but was excluded from quantitative analysis for not reporting outcomes based on individual anticoagulation therapies . Pooling of data across multiple studies using the same anticoagulation therapy was attempted, and reported outcomes were averaged across each of the studies (Table ).…”

Section: Resultsmentioning

confidence: 99%

Postoperative anticoagulation after free flap reconstruction for head and neck cancer: A systematic review

et al. 2017

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There is not adequate evidence to develop a standardized anticoagulation protocol for head and neck free flap procedures. Comparable flap complications were reported between all the employed anticoagulation methods studied, though significant variability in study design among articles existed. Prospective, randomized studies are warranted to determine the optimal postoperative anticoagulation regimen following free tissue transfer of the head and neck. Laryngoscope, 128:412-421, 2018.

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Section: Resultsmentioning

confidence: 99%

Postoperative anticoagulation after free flap reconstruction for head and neck cancer: A systematic review

et al. 2017

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“…Four authors replied positively to participating in the meta‐analysis. Finally, raw data from four studies (80%) were received and analysed . The remaining study by Sun et al .…”

Section: Resultsmentioning

confidence: 99%

“…Results and meta‐analysis of final flap failure. Univariate forest plot of studies that had a sufficient number of controls are shown (Riva and Lighthall), as well as the meta‐analysis of all included studies (Disa, Gerressen, Lighthall and Riva) . Limits represent 95% confidence interval.…”

Section: Resultsmentioning

confidence: 99%

The value of postoperative anticoagulants to improve flap survival in the free radial forearm flap: a systematic review and retrospective multicentre analysis

Swartz

Aarts

Swart

et al. 2015

Clinical Otolaryngology

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Background Free radial forearm flap (FRFF) reconstruction is a valuable technique in head and neck surgery, that allows closure of large defects while striving to maintain functionality. Anticoagulative drugs are often administered to improve flap survival, although evidence regarding effectiveness is lacking. Objective of review To investigate the effectiveness of postoperative anticoagulants to improve survival of the FRFF in head and neck reconstruction. Type of review Systematic review and multicenter, individual patient data meta-analysis. Search strategy MEDLINE, EMBASE, Web of Science and CINAHL were searched for synonyms of ‘anticoagulants’ and ‘free flap reconstruction’. Evaluation method Studies were critically appraised for directness of evidence and risk of bias. Authors of the highest quality publications were invited to submit their original data for meta-analysis. Results Five studies were of adequate quality and data from four studies (80%) were available for meta-analysis, describing 759 FRFF procedures. Anticoagulants used were: aspirin (12%), low-molecular weight dextran (18.3%), unfractioned heparin (28.1%), low-molecular weight heparin (49%) and prostaglandin-E1 (2.1%). Thirty-one percent did not receive anticoagulants. Flap failure occurred in 40 of 759 patients (5.3%) On univariate analysis, use of unfractioned heparin was associated with a higher rate of flap failure. However, these regimens were often administered to patients who had revision surgery of the anastomosis. In multivariate logistic regression analysis, anticoagulant use was not associated with improved flap survival or flap-related complications. Conclusions The studied anticoagulative drugs did not improve FRFF survival or lower the rate of flap-related complications. In addition some anticoagulants may cause systemic complications.

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“…Factors, such as older age, smoking, and radiation, are nearly universal in patients undergoing free flap reconstruction in the head and neck and have not been demonstrated to have an impact on overall flap survival . However, given the myriad of potential defects, the fine nuances of flap selection and design, available recipient vessels, and the different types of flaps introduce factors that are not encountered in reconstruction of other anatomic regions.…”

Section: Introductionmentioning

confidence: 99%

Analysis of risk factors for flap loss and salvage in free flap head and neck reconstruction

Chang

Zhang

et al. 2015

Head & Neck

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Microsurgical Free Flap Reconstructions of Head and Neck Region in 406 Cases: A 13-Year Experience

Cited by 63 publications

References 38 publications

Postoperative anticoagulation after free flap reconstruction for head and neck cancer: A systematic review

Postoperative anticoagulation after free flap reconstruction for head and neck cancer: A systematic review

The value of postoperative anticoagulants to improve flap survival in the free radial forearm flap: a systematic review and retrospective multicentre analysis

Analysis of risk factors for flap loss and salvage in free flap head and neck reconstruction

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