Complications and loss of free flaps after reconstructions for oral cancer

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Marttila , E , Thoren , H , Törnwall , J , Viitikko , A & Wilkman , T 2018 , ' Complications and loss of free flaps after reconstructions for oral cancer ' , British Journal of Oral and Maxillofacial Surgery , vol. 56 , no. 9 , pp. 835-840 . https://doi.org/10.1016/j.bjoms.2018.09.005

Title: Complications and loss of free flaps after reconstructions for oral cancer
Author: Marttila, E.; Thoren, H.; Törnwall, J.; Viitikko, A.; Wilkman, T.
Contributor: University of Helsinki, Clinicum
University of Helsinki, Department of Oral and Maxillofacial Diseases
University of Helsinki, Oral and Maxillofacial Surgery
Date: 2018-11
Language: eng
Number of pages: 6
Belongs to series: British Journal of Oral and Maxillofacial Surgery
ISSN: 0266-4356
URI: http://hdl.handle.net/10138/277480
Abstract: The aim of this retrospective study was to analyse the incidence of complications and loss of flaps after primary reconstructions for oral cancer in 191 patients at our hospital over the five years 2005-2010. The patients' clinical and personal details, characteristics of the tumours, types of microvascular flap, complications, and outcomes were recorded. The soft tissue flaps used most often were the fasciocutaneous radial forearm free flap (RFFF) (n = 86, 45%) and the anterolateral thigh free flap (ALTFF) (n = 48, 25%) while the most commonly used osseous flap was the deep circumflex iliac artery flap (DCIA) (n = 25, 13%). There were postoperative complications that required intervention in a quarter of the patients, most often in the age group 41-50 years (p = 0.018). Older age was not associated with the development of complications. The overall survival of all free flaps was 181/191 (95%), and the only significant individual predictor of loss of a flap was reconstruction with a DCIA (p = 0.016), five of the 25 of which were lost. We conclude therefore that DCIA free flaps are associated with an increased risk of failure; the method of osseous reconstruction for maxillofacial reconstruction should be selected carefully; and carefully chosen older patients do not seem to be at increased risk of morbidity. (C) 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Subject: Free flap reconstruction
complication
microsurgery
deep circumflex iliac artery flap
outcome
elderly
MANDIBULAR RECONSTRUCTION
NECK RECONSTRUCTION
HEAD
PREDICTORS
SURGERY
EXPERIENCE
SURVIVAL
FAILURE
313 Dentistry
3126 Surgery, anesthesiology, intensive care, radiology
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