title: [Reconstruction of the head and neck with free osteoseptocutaneous flap in elderly heavy smokers].
abstract: OBJECTIVE
  We evaluated complications of free flap reconstruction following oncological head and neck surgery in elderly patients who smoked heavily.
  
  
  METHODS
  The study included eight patients (2 females, 6 males; mean age 68.5 years; range 65 to 74 years) over 65 years of age, who smoked heavily (at least 1 pack/day). All cases but one with mandibular ameloblastoma had intraoral squamous cell carcinoma. Two patients underwent reconstruction with free radial forearm osteoseptocutaneous flap following bilateral maxillary resection, and six patients with free fibular osteoseptocutaneous flap following mandibular resection. Postoperative complications, in particular those associated with the donor and recipient sites were evaluated.
  
  
  RESULTS
  No partial or total flap loss was observed. Wound healing problems were seen in three patients (37%), which were at the donor site in two patients, and at the recipient site in one patient. Psychogenic disorders were observed in two patients (25%). No other complications were encountered.
  
  
  CONCLUSIONS
  Aside from some recipient- and donor-site-related healing problems, heavy smoking and advanced age cannot be regarded as contraindications for free flap reconstruction.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey. sametkuvat@yahoo.com
authors.forename: Samet Vasfi
authors.initials: SV
authors.lastname: Kuvat
authors.forename: Atakan
authors.initials: A
authors.lastname: Aydin
authors.forename: Günter
authors.initials: G
authors.lastname: Hafiz
authors.forename: Ismet
authors.initials: I
authors.lastname: Aslan
authors.forename: Emre
authors.initials: E
authors.lastname: Hocaoğlu
authors.forename: Ahmet
authors.initials: A
authors.lastname: Biçer
authors.forename: Bülent
authors.initials: B
authors.lastname: Yaprak
authors.forename: Omer
authors.initials: O
authors.lastname: Berköz
mesh_terms: D000368:Aged; D000564:Ameloblastoma / Q000209:etiology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000601:surgery*; D000075202:Contraindications; D020821:Dystonic Disorders / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008339:Mandibular Neoplasms / Q000209:etiology / Q000601:surgery; D009062:Mouth Neoplasms / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications; D012907:Smoking / Q000009:adverse effects*; D013524:Surgical Flaps / Q000009:adverse effects*; D014945:Wound Healing