Free flaps and literature review

Background: Microvascular free flaps are a reliable and efficient method for restoring head and neck defects. Here we describe 169 free flap procedures, and determine the success rate of these reconstructions. Methods: This study included data from all patients who underwent microsurgical reconstruction for head and neck defects at St. John’s Hospital in Bruges between 1994 and 2012. We analysed sex, age, American Society of Anaesthesiologists (ASA) score, smoking, prior radiotherapy, and deep circumflex iliac artery (DCIA) harvesting technique to determine their influences on flap complications and overall complications. Results: Our study included 169 free flap procedures, with a flap success rate of 92%. The rate of systemic complications was 21%. The DCIA split harvesting technique was associated with a significantly higher incidence of flap complications. Increased age (³57 years) was associated with a higher incidence of overall complications. Conclusion: In our present series, the DCIA split harvesting technique was associated with a significantly higher frequency of total flap failure. This increased failure rate was attributed to important haematomas that compromised venous circulation. We also found that patient age was a significant factor for the development of postoperative complications.