MICROVASCULAR FREE FLAPS IN HEAD AND NECK-SURGERY

This study is a retrospective review of 60 patients who had microvascu lar free flap reconstructions in the head and neck region. They were a ll performed over a 10-year period by a single surgeon. The series inc ludes a wide range of flap types and analyses pre-operative risk facto rs for flap failure as well as complications and outcome. Smoking and advanced age did not appear to prejudice flap survival but peripheral vascular disease, cardiac disease and alcohol withdrawal were found to increase the likelihood of flap failure. The most frequent complicati ons encountered were thrombosis of one of the anastomosis and haematom a. The most successful flap in terms of survival and function was the fasciocutaneous radial forearm flap. The literature is reviewed in rel ation to the general principles of microvascular free flap surgery and the results of this series are placed in context.