DOES PRIOR IRRADIATION INCREASE THE RISK OF TOTAL OR PARTIAL FREE-FLAP LOSS

Answers to the question, ''Does previous irradiation of a recipient si te interfere with reconstruction by free-tissue transfer?'' have been elusive. In an attempt to address that question, all free-flap procedu res performed for reconstruction of the breast or of head and neck def ects at the University of Texas M. D. Anderson Cancer Center between M ay 1, 1988 and February 15, 1996 were reviewed. The effects of prior i rradiation of the recipient site on the incidence of total flap loss, partial flap loss, and thrombosis were assessed. During the study peri od, 1384 eligible free-flap reconstructions were performed. Total flap loss and partial flap loss were more common in the 428 flaps transfer red to previously irradiated sites than in the patients without previo us irradiation, but multiple logistic regression analysis showed that these differences were due to confounding factors. The authors conclud e that previous irradiation of flap recipient sites does not statistic ally significantly affect the rate of partial or total free-flap loss.