title: Microvascular free tissue reconstruction following extirpation of head and neck tumour: experience towards an optimal outcome.
abstract: Familiarity with four types of free tissues transfers allows appropriate reconstruction of most defects in the head and neck region functionally and aesthetically. These include jejunal graft, radial forearm, rectus abdominus myocutaneous and fibula osteocutaneous flaps. Free colonic and gastric patches were used occasionally. We report our experience of 215 free tissue transfers for reconstruction of defects in the head and neck region after tumour extirpation. The overall success rate was 94 per cent. The commonest cause of failure was related to arterial inflow (70 per cent). Three patients died in hospital, but their mortality was not related to the tissue transfers. Complications due to free tissue transfer at both the donor and recipient sites were few and manageable. The co-operation between the two surgical teams, together with the timely application of suitable salvage procedures, contribute to an optimal outcome.
authors.affiliation: Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong.
authors.forename: L K
authors.initials: LK
authors.lastname: Lam
authors.forename: William I
authors.initials: WI
authors.lastname: Wei
authors.forename: Vana S H
authors.initials: VS
authors.lastname: Chan
authors.forename: Raymond W M
authors.initials: RW
authors.lastname: Ng
authors.forename: W K
authors.initials: WK
authors.lastname: Ho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D017211:Treatment Failure; D016896:Treatment Outcome