[Clinical observation and treatment of failing flaps in oral and maxillofacial surgery: a report of 44 cases].
OBJECTIVE
For the purpose of enhancing the successful transplanting rate of free flaps and reviewing the clinical characters, a retrospective study was undertaken to analyze the causes as well as clinical characters of the failing flap in oral and maxillofacial regions.


METHODS
A total of 832 free revascularized flaps were performed in our department from August 1997 to April 2003. The data including the time to occurence, causes, clinical characters and the managements of flap crises were reviewed and then analyzed.


RESULTS
Forty-four flaps developed vascular crisis (5.29%), most of them were caused by venous occlusion (38/44). Thirty-eight in forty-four flaps crises occurred within 72 hours (86.36%). 32 flaps crises were explored with 21 flaps successfully salvaged; the success rate was as high as 65.63%.


CONCLUSIONS
For the highest successful transplanting rate of free flaps, the management of the local factors plays an important role. Most of the failing flaps happened within three days after operation. The surgical exploration should be done as soon as possible, if the crises flap happened within six hours.
Ye
Wei-min
WM
Department of Oral & Maxillofacial Surgery, School of Stomatology, Ninth People's Hospital, Shanghai Second Medical University. Shanghai 200011,China.
Zhang
Zhi-yuan
ZY
Zhu
Han-guang
HG
Sun
Jian
J
Zhang
Chen-ping
CP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013515:Surgery, Oral; D013524:Surgical Flaps / Q000009:adverse effects*