Head and neck reconstruction with free vascularized flaps; our experience

Abstract

Objectives The available data of the use of free vascularized flaps in head and neck reconstruction in a single centre is presented. Materials and Methods All patients who received a free vascularized flap in our department in the past 5 years (2017-2021) were recorded. Results 21 patients were included, 20 oncologic patients and self-inflicted gunshot injury patient. As far as the oncologic patients are concerned, 10 patients received a free flap in the same stage as tumour resection, 4 received a free flap after disease recurrence, and 6 received a free flap after a disease-free period, either for a post-surgical correction of a deformity or to manage post-therapy complications, such as osteoradionecrosis or trismus. In total the survival rate of the oncologic patients is 60%. No major post-surgical complications were observed as far as the flap survival was concerned. The anterolateral thigh flap and fibula flap were the most preferred for reconstruction in 8 and 8 cases respectively. The radial forearm free flap was used in 3 patients and the gracilis flap in 2 patients. Conclusion The contribution of our Department in the use of free vascularized flaps, despite small, indicates that they can be effectively used in patients either as immediate reconstruction or a reconstruction in a 2-step approach. Mortality rates are associated with disease recurrence or other major comorbidities of the patients. This experience can be the basis for further expansion of the free flap reconstruction surgery in our Department. ​