Free flaps: outcomes and complications in head and neck reconstructions.
Between 2000 and 2007, 376 free-flap transfers were performed in 352 patients at the Department of Maxillofacial Surgery, University of Parma, Italy. They included 303 reconstructions after cancer surgery (80.6%), 28 secondary reconstructions (7.4%), 32 transfers for facial paralysis (8.5%) and 13 reconstructions for other pathology (3.5%) such as osteonecrosis and ameloblastoma. We determined the rates of major and minor flap, donor-site and systemic complications and analysed their relationships with factors such as aetiology, patient age, smoking history and the presence of comorbid conditions. For the free flaps examined in this study, the overall complication rate was 47%. Major complications occurred in 20.7% of the cases and minor complications in 26.3%. The major flap, donor-site and systemic complication rates were 11.9, 3.2 and 5.6%, respectively. Total flap loss occurred in 15 cases (4%). The minor flap, donor-site and systemic complication rates were 19.1, 4 and 3.2% respectively. Aetiology, patient age, smoking history and the presence of comorbid conditions were related to higher rates of major and minor complications, although these were not statistically significant.
Bianchi
Bernardo
B
Maxillofacial Surgery, Head and Neck Department, University-Hospital of Parma, Via Gramsci 14, 43100 Parma (Pr), Italy.
Copelli
Chiara
C
Ferrari
Silvano
S
Ferri
Andrea
A
Sesenna
Enrico
E
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000564:Ameloblastoma / Q000601:surgery; D002648:Child; D048909:Diabetes Complications; D005158:Facial Paralysis / Q000601:surgery; D005260:Female; D006085:Graft Survival; D006257:Head / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D010020:Osteonecrosis / Q000601:surgery; D011183:Postoperative Complications; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013524:Surgical Flaps / Q000009:adverse effects / Q000473:pathology; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013927:Thrombosis / Q000209:etiology; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult