Second free flaps in head and neck reconstruction. 2012

Gary Ross, and Tuija M Yla-Kotola, and David Goldstein, and Toni Zhong, and Ralph Gilbert, and Jonathan Irish, and Patrick J Gullane, and Stefan O P Hofer, and Peter C Neligan
Division of Plastic & Reconstructive Surgery, University Health Network, 200 Elizabeth Street, 8N-865, Toronto, ON M5G 2C4, Canada.

BACKGROUND Ablative surgery for head and neck cancer often results in defects that require free flap reconstruction. Improved survival after refined oncologic and adjuvant techniques has led to an increase in the number of patients undergoing a second free flap reconstruction. The objective of this study was to assess outcomes following a second free flap in head and neck reconstruction. METHODS Following ablative defects in the head and neck, 1475 patients underwent reconstructive surgery over a period of 17 years. A second free flap for reconstruction was performed on 123 of these patients. In Group 1, 93 patients had a reconstruction for either tumour recurrence, second primary tumour or reconstructive complications (fractured plate, osteoradionecrosis, orocutaneous fistula). In Group 2, 30 patients had a second free flap following primary free flap reconstructive failure. RESULTS Flap success for Group 1 patients was 86/90 (96%) compared to group 2 patients, 22/30 (73%) (p < 0.05). In Group 1, partial necrosis occurred in four patients whereas in Group 2, there was only one partial necrosis (NS; p > 0.05). CONCLUSIONS A second free flap may be required for reconstruction of head and neck defects following complications of the initial reconstruction, presence of a second primary or tumour recurrence. Success rates for second free flap reconstructions were significantly lower in those patients with initial free flap failure.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006084 Graft Rejection An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. Transplant Rejection,Rejection, Transplant,Transplantation Rejection,Graft Rejections,Rejection, Graft,Rejection, Transplantation,Rejections, Graft,Rejections, Transplant,Rejections, Transplantation,Transplant Rejections,Transplantation Rejections
D006085 Graft Survival The survival of a graft in a host, the factors responsible for the survival and the changes occurring within the graft during growth in the host. Graft Survivals,Survival, Graft,Survivals, Graft
D006258 Head and Neck Neoplasms Soft tissue tumors or cancer arising from the mucosal surfaces of the LIP; oral cavity; PHARYNX; LARYNX; and cervical esophagus. Other sites included are the NOSE and PARANASAL SINUSES; SALIVARY GLANDS; THYROID GLAND and PARATHYROID GLANDS; and MELANOMA and non-melanoma skin cancers of the head and neck. (from Holland et al., Cancer Medicine, 4th ed, p1651) Cancer of Head and Neck,Head Cancer,Head Neoplasm,Head and Neck Cancer,Head and Neck Neoplasm,Neck Cancer,Neck Neoplasm,Neck Neoplasms,Neoplasms, Upper Aerodigestive Tract,UADT Neoplasm,Upper Aerodigestive Tract Neoplasm,Upper Aerodigestive Tract Neoplasms,Cancer of Head,Cancer of Neck,Cancer of the Head,Cancer of the Head and Neck,Cancer of the Neck,Head Neoplasms,Head, Neck Neoplasms,Neoplasms, Head,Neoplasms, Head and Neck,Neoplasms, Neck,UADT Neoplasms,Cancer, Head,Cancer, Neck,Cancers, Head,Cancers, Neck,Head Cancers,Neck Cancers,Neoplasm, Head,Neoplasm, Neck,Neoplasm, UADT,Neoplasms, UADT
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

Related Publications

Gary Ross, and Tuija M Yla-Kotola, and David Goldstein, and Toni Zhong, and Ralph Gilbert, and Jonathan Irish, and Patrick J Gullane, and Stefan O P Hofer, and Peter C Neligan
August 1998, Journal of reconstructive microsurgery,
Gary Ross, and Tuija M Yla-Kotola, and David Goldstein, and Toni Zhong, and Ralph Gilbert, and Jonathan Irish, and Patrick J Gullane, and Stefan O P Hofer, and Peter C Neligan
July 1993, The Western journal of medicine,
Gary Ross, and Tuija M Yla-Kotola, and David Goldstein, and Toni Zhong, and Ralph Gilbert, and Jonathan Irish, and Patrick J Gullane, and Stefan O P Hofer, and Peter C Neligan
March 1980, Canadian journal of surgery. Journal canadien de chirurgie,
Gary Ross, and Tuija M Yla-Kotola, and David Goldstein, and Toni Zhong, and Ralph Gilbert, and Jonathan Irish, and Patrick J Gullane, and Stefan O P Hofer, and Peter C Neligan
July 2005, Clinics in plastic surgery,
Gary Ross, and Tuija M Yla-Kotola, and David Goldstein, and Toni Zhong, and Ralph Gilbert, and Jonathan Irish, and Patrick J Gullane, and Stefan O P Hofer, and Peter C Neligan
November 2006, Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery,
Gary Ross, and Tuija M Yla-Kotola, and David Goldstein, and Toni Zhong, and Ralph Gilbert, and Jonathan Irish, and Patrick J Gullane, and Stefan O P Hofer, and Peter C Neligan
September 2006, Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery,
Gary Ross, and Tuija M Yla-Kotola, and David Goldstein, and Toni Zhong, and Ralph Gilbert, and Jonathan Irish, and Patrick J Gullane, and Stefan O P Hofer, and Peter C Neligan
October 1990, American journal of surgery,
Gary Ross, and Tuija M Yla-Kotola, and David Goldstein, and Toni Zhong, and Ralph Gilbert, and Jonathan Irish, and Patrick J Gullane, and Stefan O P Hofer, and Peter C Neligan
January 1994, Clinics in plastic surgery,
Gary Ross, and Tuija M Yla-Kotola, and David Goldstein, and Toni Zhong, and Ralph Gilbert, and Jonathan Irish, and Patrick J Gullane, and Stefan O P Hofer, and Peter C Neligan
October 1990, Clinics in plastic surgery,
Gary Ross, and Tuija M Yla-Kotola, and David Goldstein, and Toni Zhong, and Ralph Gilbert, and Jonathan Irish, and Patrick J Gullane, and Stefan O P Hofer, and Peter C Neligan
August 2021, Current opinion in otolaryngology & head and neck surgery,
Copied contents to your clipboard!