title: Free tissue transfer reconstruction of the head and neck at a Veterans Affairs hospital.
abstract: BACKGROUND
  The Veterans Affairs (VA) population is considered to have generally poorer health than its non-VA counterpart.
  
  
  METHODS
  We reviewed our experience with 55 consecutive patients undergoing free tissue transfers for head and neck reconstruction at the Dallas VA Hospital between July 2000 and September 2006, with 6 months' follow-up.
  
  
  RESULTS
  The overall success rate was 93% (51 of 55 flaps). Factors affecting flap survival were fasciocutaneous flap versus others (p = .01) and minimal versus excessive intraoperative crystalloid administration (p = .03). Nine different flaps were used. Major and minor complications occurred in 33% (n = 18) and 31% (n = 17) patients, respectively. Average intensive care unit and hospital stays were 7.4 and 16.0 days, respectively.
  
  
  CONCLUSIONS
  Free flaps for head and neck reconstructions in the VA population can be performed with excellent success rates. Complication rates and hospital days in this population are similar to those of the non-VA populations. Flap selection and administration of minimal intraoperative fluids are important.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA. larry.myers@utsouthwestern.edu
authors.forename: Larry L
authors.initials: LL
authors.lastname: Myers
authors.forename: Baran D
authors.initials: BD
authors.lastname: Sumer
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Defatta
authors.forename: Abu
authors.initials: A
authors.lastname: Minhajuddin
mesh_terms: D000328:Adult; D000368:Aged; D016025:Bone Transplantation; D005260:Female; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006787:Hospitals, Veterans; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D013524:Surgical Flaps / Q000098:blood supply