J Reconstr Microsurg 2008; 24(3): 183-187
DOI: 10.1055/s-2008-1076754
© Thieme Medical Publishers

A Ten-Year Experience of Multiple Flaps in Head and Neck Surgery: How Successful Are They?

Gary L. Ross1 , Erik E. Ang S.W.2 , Declan Lannon3 , Patrick Addison3 , Alex Golger3 , Christine B. Novak4 , Joan E. Lipa5 , Patrick J. Gullane6 , Peter C. Neligan7
  • 1Division of Plastic Surgery, Christie Hospital, Manchester, United Kingdom
  • 2Division of Plastic Surgery, Mount Elizabeth Hospital, Singapore
  • 3Division of Plastic Surgery, University Health Network, University of Toronto
  • 4Wharton Head and Neck Centre, University Health Network, University of Toronto
  • 5Division of Plastic Surgery, University of California, Los Angeles, California
  • 6Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto
  • 7Division of Plastic Surgery, University of Washington, Seattle, Washington
Further Information

Publication History

Publication Date:
05 May 2008 (online)

ABSTRACT

Ablative surgery in the head and neck often results in defects that require free flap reconstruction. With improved ablation/reconstructive and adjuvant techniques, improved survival has led to an increase in the number of patients undergoing multiple free flap reconstruction. We retrospectively analyzed a single institution’s 10-year experience (August 1993 to August 2003) in free flap reconstruction for malignant tumors of the head and neck. Five hundred eighty-two flaps in 534 patients were identified with full details regarding ablation and reconstruction with a minimum of 6-month follow-up. Of these 584 flaps, 506 were for primary reconstruction, 50 for secondary reconstruction, 12 for tertiary reconstruction, and 8 patients underwent two flaps simultaneously for extensive defects. Overall flap success was 550/584 (94%). For primary free flap surgery, success was 481/506 (95%), compared with 44/50 (88%) for a second free flap reconstruction and 9/12 (75%) for a third free flap reconstruction (p < 0.05). Eight extensive defects were reconstructed with 16 flaps, all of which were successful. More than one free flap may be required for reconstruction of head and neck defects, although success decreases as the number of reconstructive procedures increases.

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Gary L RossM.D. F.R.C.S.(Plast.) 

Division of Plastic Surgery, Christie Hospital

Manchester, United Kingdom