Analysis of 49 Cases of Flap Compromise in 1,310 Free Flaps for Head and Neck Reconstruction
A. McKechnie
Abstract
All patients undergoing free flap reconstruction of head and neck defects between 1995 and 2006 were included. Data on causes and factors related to flap compromise were collected. Patients with intraoperative thrombosis that was revised without further consequences were not included in the group of compromised or failed flaps. Patients underwent free flap reconstruction of head and neck defects and were managed according to the centre's standard perioperative care routine. Selection bias may therefore have skewed the results of this study. The authors admitted that the rate of flap compromise and loss was too low to allow meaningful analysis of predisposing factors, a fact that might allow the authors a deserved sense of satisfaction. The use of a dedicated intensive care facility and “flap floor” solely for the purpose of postoperative care of reconstruction patients, highly experienced nursing staff, and ease of access to theatres are all indicative of an institutional dedication to high-quality care.