The evolving role of free flaps and pedicled flaps in head and neck reconstruction

Abstract

Although osteocutaneous microvascular free flaps remain the standard of care for composite oromandibular defects, there may be a groundswell in the use of certain locoregional pedicled flaps for reconstructing many facial, intraoral and pharyngeal soft tissue defects. Evolution in the use of these locoregional flaps may help improve upon the standard of care for reconstructive options.

Reconstrucción de cabeza y cuello mediante colgajos libres microvascularizados. Indicaciones, aspectos técnicos y resultados

“…La utilización de colgajos locorregionales, principalmente del colgajo miocutáneo de pectoral mayor, continúa siendo la opción reconstructiva en la mayoría de los centros 3 . Sin embargo, actualmente la utilización de CLM se ha convertido en el método de reconstrucción de elección, sobre todo para defectos complejos 4,5 . La elección del tipo de reconstrucción está influida por el estado general del paciente, por las caracterís-ticas del defecto a reconstruir, por la experiencia del equipo quirúrgico.…”

Results of free flap reconstruction for patients aged 80 years or older with head and neck cancer

“…The following standard conversion ratios were utilized to assess ethanol consumption per Japanese drink: 180 mL of sake was considered as equal to 22 g of ethanol; 633 mL of beer to 25 g of ethanol; 180 mL of shochu to 36 g of ethanol; 120 mL of wine to 11 g of ethanol; and 30 mL of whiskey to 10 g of ethanol. Drinking status was categorized into 3 groups: [1] never or rare drinkers [2]; moderate drinkers (<4 units [1 unit 5 12.5 g of ethanol equivalent]) per day); and [3] high drinker (four or more units per day).…”

“…Microvascular free flap tissue transfer has become the gold standard for reconstructing composite defects after radical resection of head and neck cancers [2]. In the past, advanced age was considered as contraindication for free flap surgery, but this perception has been changing over the last decades.…”

Pre-expanded occipito-dorsal flap reconstruction for neck burns: A novel approach

“…Currently, a variety of techniques are available to burn reconstructive surgeons, among which transfer of expanded microvascular flaps has perhaps become the most favored option worldwide. [1] This technique often allows for reconstruction of large areas with good quality transposition or rotational flaps with a near-perfect match in skin color and texture, thus generating excellent aesthetic results. Nevertheless, expanded free flap transfer is associated with numerous complications include infection, extrusion, hematoma, flap ischemia and expander perforation.…”