title: Microsurgical reconstruction of the head and neck--current concepts of maxillofacial surgery in Europe.
abstract: BACKGROUND
  Microvascular surgery following tumour resection has become an important field of oral maxillofacial surgery (OMFS). This paper aims to evaluate current microsurgical practice in Europe.
  
  
  METHODS
  The questionnaire of the DOESAK collaborative group for Microsurgical Reconstruction was translated into English, transformed into an online based survey and distributed to 200 OMFS units with the aid of the European Association for Cranio-Maxillo-Facial Surgery (EACMFS).
  
  
  RESULTS
  65 complete and 72 incomplete questionnaires were returned. Hospitals from the United Kingdom, France, Italy, the Netherlands, Spain, Belgium, Greece, Slovenia and Lithuania participated. 71% of contributing centres were university hospitals, 87% out of these perform microvascular tumour surgery at least on a two-weekly base. Overall complication rate was at around five percent. Most frequently used transplants were the radial forearm flap and the fibular flap. The perioperative management varied widely. Success factors for flap survival, however, were uniformly rated, with the surgical skill being the most important factor, followed by the quality of postoperative management. Medication seems to play a less important role.
  
  
  CONCLUSIONS
  Within Europe microvascular surgery is a common and safe procedure for maxillofacial reconstructive surgery in the field of OMFS. While there is a major accordance for the surgical procedure itself and the most frequently used flaps, perioperative management shows a wide variety of protocols with low presumed impact on surgical outcome.
authors: Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. Electronic address: katinka.kansy@med.uni-heidelberg.de.
authors: Katinka
authors: K
authors: Kansy
authors: Department of Oral and Maxillofacial Surgery, Universitätsspital Basel, University of Basel, Basel, Switzerland.
authors: Andreas Albert
authors: AA
authors: Mueller
authors: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors: Thomas
authors: T
authors: Mücke
authors: Department of Oral and Maxillofacial Surgery, Universitätsspital Basel, University of Basel, Basel, Switzerland.
authors: Jean-Baptiste
authors: JB
authors: Kopp
authors: Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
authors: Friederike
authors: F
authors: Koersgen
authors: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors: Klaus Dietrich
authors: KD
authors: Wolff
authors: Department of Oral and Maxillofacial Surgery, Universitätsspital Basel, University of Basel, Basel, Switzerland.
authors: Hans-Florian
authors: HF
authors: Zeilhofer
authors: Department of Oral and Maxillofacial Surgery, Aachen University Hospital, Aachen, Germany.
authors: Frank
authors: F
authors: Hölzle
authors: Department of Oral and Maxillofacial Surgery, Dresden University Hospital, Dresden, Germany.
authors: Winnie
authors: W
authors: Pradel
authors: Department of Oral and Maxillofacial Surgery, Dresden-Neustadt Hospital, Dresden, Germany.
authors: Matthias
authors: M
authors: Schneider
authors: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors: Andreas
authors: A
authors: Kolk
authors: Department of Oral and Maxillofacial Surgery, Hamburg University Hospital, Hamburg-Eppendorf, Germany.
authors: Ralf
authors: R
authors: Smeets
authors: Department of Oral and Maxillofacial Surgery, Hospital Universitario Ramón y Cajal, University of Alcala, Madrid, Spain.
authors: Julio
authors: J
authors: Acero
authors: Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
authors: Jürgen
authors: J
authors: Hoffmann
mesh_terms: D000714:Anastomosis, Surgical / Q000639:trends; D000925:Anticoagulants / Q000627:therapeutic use; D016025:Bone Transplantation / Q000379:methods; D002983:Clinical Competence; D005060:Europe; D058752:Free Tissue Flaps / Q000637:transplantation; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006785:Hospitals, University; D006801:Humans; D007430:Intraoperative Care; D008866:Microsurgery / Q000639:trends*; D008991:Monitoring, Physiologic / Q000639:trends; D018482:Muscle, Skeletal / Q000637:transplantation; D019647:Oral Surgical Procedures / Q000639:trends; D011182:Postoperative Care; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000639:trends*; D012086:Reoperation / Q000639:trends; D014656:Vascular Surgical Procedures / Q000639:trends
chemical_list: D000925:Anticoagulants
keywords: Drug therapy; Europe; Free tissue flaps; Microsurgery; Operative surgical procedure; Peri- and postoperative management