Abstract

This study describes all of the cases of free flap reconstruction performed in our institution and aims to ana¬lyze the results, causes of success or failure of these cases and to summarize and analyse the results. Methods: This retrospective analysis was done over a period 18 months with review of 25 cases who had undergone free flap transfer after tumour resection in the head and neck between April 2017 and March 2020. For each patient, data on age and sex, and anatomical location of the tumor, as well as reconstructive vari¬ables were collected. Flap monitoring is done every 2 hours in the first 24 hours and every 4 hours for the next 48 hours and every 6 hours for the later period. The main outcomes assessed were the types of flap used to reconstruct primary defects, success rates, flap results according to the primary defect and selected recipient vessels, results of the salvage operation, and the success or failure of the cases. Results: A total of 26 free flaps were used in 25 patients in the study period. Out of these 25 cases, 17 (68%) were males and 08 (32%) were females. The anterolat¬eral thigh free flap (ALT) was most commonly used, being performed in 11 cases and accounting for 45% of the soft tis¬sue reconstructive surgeries. The second most common flap was the radial forearm free flap (RFF), which was performed in 09 cases (36%). For the reconstruction of bony defects, mostly mandible, the osteocutaneous fibu¬lar free flap was chosen most frequently, and was used in 04 cases (16%). 02 cases required rectus abdominis flap. Conclusion: Microvascular flap surgery should be performed in quality manner with cautious anastomosis and vigorous monitoring which leads to better control of disease, because the possibility of bridging extended tissue defects can push surgeons to perform more aggressive resections and reconstructing the defect both anatomically and functionally without compromising oncological principle.

Description