Unfavorable Results After Free Tissue Transfer to Head and Neck: Lessons Learned at the University of Washington.
This article discusses the lessons learned from nearly 2700 free tissue transfer procedures to reconstruct defects of the head and neck at the University of Washington. It discusses the authors' perioperative management practices regarding perioperative tracheotomy tube placement, their method of postoperative flap monitoring, and their current protocol for use of postoperative antibiotics. It reports on the reconstructive preferences for 2 difficult defects that frequently result in unfavorable outcomes: the total glossectomy defect and the pharyngolaryngectomy defect. Key points for harvesting and insetting flaps, to maximize reconstructive outcomes, are provided.
Department of Otolaryngology, University of Washington, 1959 Northeast Pacific Street, Box 356515, Seattle, WA 98195, USA. Electronic address: jhoulton@uw.edu.
Jeffrey J
JJ
Houlton
Department of Otolaryngology, University of Washington, 1959 Northeast Pacific Street, Box 356515, Seattle, WA 98195, USA.
Scott E
SE
Bevans
Department of Otolaryngology, University of Washington, 1959 Northeast Pacific Street, Box 356515, Seattle, WA 98195, USA.
Neal D
ND
Futran
D058752:Free Tissue Flaps / Q000009:adverse effects* / Q000098:blood supply; D006257:Head / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D009333:Neck / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000209:etiology / Q000601:surgery*
Antibiotics; Free flap reconstruction; Free tissue transfer; Jejunal free flap; Laryngopharyngectomy; Total cervical esophagectomy; Total glossectomy; Tracheotomy tube placement