Christian Corbitt, Roman J Skoracki, Peirong Yu, Matthew M Hanasono
{"title":"头颈部重建游离皮瓣失败。","authors":"Christian Corbitt, Roman J Skoracki, Peirong Yu, Matthew M Hanasono","doi":"10.1002/hed.23471","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to determine the causes of head and neck free flap loss and to evaluate outcomes after subsequent microvascular and non-microvascular reconstruction.</p><p><strong>Methods: </strong>Patients who experienced free flap loss between 2000 and 2012 were reviewed.</p><p><strong>Results: </strong>There were 40 flap losses out of 3090 free flaps (1.3%). Twenty-eight patients underwent subsequent free flap reconstruction of which 27 free flaps were successful (96.4%), which was not significantly different from our initial flap success rate (p = .81). Of patients who underwent subsequent free flap reconstruction for oral/pharyngeal defects, 100% had >80% speech intelligibility and 87.5% were tube feed independent. By comparison, 42.9% of patients who underwent subsequent pectoralis major flap reconstruction had intelligible speech (p = .01) and 25.0% were independent of tube feeds (p = 0.02).</p><p><strong>Conclusion: </strong>Subsequent free flaps after initial free flap losses can be successful in selected patients. Functional outcomes after subsequent free flap reconstruction are favorable compared to pedicled flap reconstruction.</p>","PeriodicalId":501638,"journal":{"name":"Head & Neck","volume":" ","pages":"1440-5"},"PeriodicalIF":0.0000,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hed.23471","citationCount":"91","resultStr":"{\"title\":\"Free flap failure in head and neck reconstruction.\",\"authors\":\"Christian Corbitt, Roman J Skoracki, Peirong Yu, Matthew M Hanasono\",\"doi\":\"10.1002/hed.23471\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The purpose of this study was to determine the causes of head and neck free flap loss and to evaluate outcomes after subsequent microvascular and non-microvascular reconstruction.</p><p><strong>Methods: </strong>Patients who experienced free flap loss between 2000 and 2012 were reviewed.</p><p><strong>Results: </strong>There were 40 flap losses out of 3090 free flaps (1.3%). Twenty-eight patients underwent subsequent free flap reconstruction of which 27 free flaps were successful (96.4%), which was not significantly different from our initial flap success rate (p = .81). Of patients who underwent subsequent free flap reconstruction for oral/pharyngeal defects, 100% had >80% speech intelligibility and 87.5% were tube feed independent. By comparison, 42.9% of patients who underwent subsequent pectoralis major flap reconstruction had intelligible speech (p = .01) and 25.0% were independent of tube feeds (p = 0.02).</p><p><strong>Conclusion: </strong>Subsequent free flaps after initial free flap losses can be successful in selected patients. Functional outcomes after subsequent free flap reconstruction are favorable compared to pedicled flap reconstruction.</p>\",\"PeriodicalId\":501638,\"journal\":{\"name\":\"Head & Neck\",\"volume\":\" \",\"pages\":\"1440-5\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2014-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1002/hed.23471\",\"citationCount\":\"91\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Head & Neck\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/hed.23471\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2014/2/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Head & Neck","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/hed.23471","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2014/2/1 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Free flap failure in head and neck reconstruction.
Background: The purpose of this study was to determine the causes of head and neck free flap loss and to evaluate outcomes after subsequent microvascular and non-microvascular reconstruction.
Methods: Patients who experienced free flap loss between 2000 and 2012 were reviewed.
Results: There were 40 flap losses out of 3090 free flaps (1.3%). Twenty-eight patients underwent subsequent free flap reconstruction of which 27 free flaps were successful (96.4%), which was not significantly different from our initial flap success rate (p = .81). Of patients who underwent subsequent free flap reconstruction for oral/pharyngeal defects, 100% had >80% speech intelligibility and 87.5% were tube feed independent. By comparison, 42.9% of patients who underwent subsequent pectoralis major flap reconstruction had intelligible speech (p = .01) and 25.0% were independent of tube feeds (p = 0.02).
Conclusion: Subsequent free flaps after initial free flap losses can be successful in selected patients. Functional outcomes after subsequent free flap reconstruction are favorable compared to pedicled flap reconstruction.