Complications after microsurgical tissue transfer in the head and neck region.
In recent years, the use of microsurgically re-anastomosed free transplants has become a proven technique for the reconstruction of defects in the head and neck region, which is demanding from both aesthetic and functional points of view. A retrospective catamnestic study on 227 free tissue transfers in the Department for Oral and Maxillofacial Surgery at the University of Tübingen showed good healing with relatively low failure rates of the transplants used. A significant proportion of local complications, arising postoperatively, was to some degree due to pre-existing medical conditions, tumour-specific pretreatments and the particular wound-healing situation found in head and neck interventions. The highest relative rate of complications at the site of origin was seen amongst osteomuscular transplants (20%) whilst (fascio) cutaneous and visceral transplants were found to result in a low percentage of problems (4%). In contrast, the healing of iliac crest transplants was accompanied by various local complications in 12% of the cases, slightly higher than 20% amongst (fascio) cutaneous and abdominal transplants and well above 30% for latissimusdorsi and scapular transplants. General complications, in particular of a respiratory and/or psychiatric nature, were found in 23% of the patients.
Department of Oral and Maxillofacial Surgery, Eberhard-Karls-University of Tübingen, Germany. juergen.hoffmann@uni-tuebingen.de
J
J
Hoffmann
M
M
Ehrenfeld
S
S
Hwang
N
N
Schwenzer
D000328:Adult; D000367:Age Factors; D000714:Anastomosis, Surgical / Q000009:adverse effects; D001237:Asphyxia / Q000209:etiology / Q000601:surgery; D016025:Bone Transplantation / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D004954:Esthetics; D005205:Fascia / Q000637:transplantation; D005260:Female; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects*; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D010019:Osteomyelitis / Q000209:etiology; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012086:Reoperation; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000009:adverse effects*; D013524:Surgical Flaps / Q000009:adverse effects*; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D013927:Thrombosis / Q000209:etiology; D014139:Tracheostomy; D016896:Treatment Outcome; D014945:Wound Healing