title: Head and neck reconstruction with a second free flap following resection of a recurrent malignancy.
abstract: A retrospective analysis of 12 patients with a head and neck tumor recurrence within a previous free flap treated with extirpation and a second free flap is reported. A 15-year experience at Mayo Clinic, Rochester, from 1988 to 2003 of 12 patients (5 men, 7 women) who underwent 25 free flaps is reviewed. The overall flap survival rate was 92%, with a 100% survival rate in the first free-tissue transfer and 85% survival rate in the second free-tissue transfer. There was 1 minor complication (8%) and there were 2 major complications (15%) among the second free flaps. Overall, 10 of 13 (77%) second free flaps were anastomosed to ipsilateral neck vessels. Moreover, in 5 of 13 cases (38%) the same artery and in 7 of 13 cases (54%) the same vein were used for both the first and second free flaps. Reconstruction of the head and neck with a second free flap in patients with a recurrent tumor is safe and effective. The original recipient vessels can often be used for the second reconstruction.
authors.affiliation: Division of Plastic Surgery, Mayo Clinic, Rochester, MN 55905, USA. Knoetgen.James@mayo.edu
authors.forename: James
authors.initials: J
authors.lastname: Knoetgen
authors.forename: Umar
authors.initials: U
authors.lastname: Choudry
authors.forename: Stephan J
authors.initials: SJ
authors.lastname: Finical
authors.forename: Craig H
authors.initials: CH
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D009367:Neoplasm Staging; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps