Pohlenz Philipp, Blessmann Marco, Heiland Max, Blake Felix, Schmelzle Rainer, Li Lei
Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Craniomaxillofac Surg. 2007 Sep-Oct;35(6-7):311-5. doi: 10.1016/j.jcms.2007.05.001. Epub 2007 Sep 14.
This retrospective study was intended to determine the incidence and causes of postoperative complications in patients following head and neck reconstruction using microvascular free flaps.
A total of 202 consecutive microvascular free flaps were performed for reconstruction of the head and neck by the same surgeon, 85% of the defects arose following the treatment of malignancies. Flap donor sites included latissimus-dorsi flap (n=83), radial forearm (n=35), fibula (n=31), iliac crest (n=36), TRAM flap (n=3), groin flap (n=l), jejunal flap (n=13). The incidence of postoperative complications and patient-related characteristics (age, sex, diagnosis, comorbidity level, operation duration, defect site, history of radiotherapy/chemotherapy) were retrospectively analyzed.
Free flaps proved to be extremely reliable, with a 2.9% incidence of free flap failure. Postoperative medical complications occurred in 11.4% of cases, with cardiac, pulmonary and infectious complications predominating.
The present study confirms that free flaps are extremely reliable in achieving successful reconstruction of the head and neck. The incidence of postoperative complications is related to the preoperative comorbidity.
本回顾性研究旨在确定采用游离微血管皮瓣进行头颈部重建患者术后并发症的发生率及原因。
同一位外科医生连续进行了202例游离微血管皮瓣头颈部重建手术，85%的缺损是在恶性肿瘤治疗后出现的。皮瓣供区包括背阔肌皮瓣（n = 83）、桡侧前臂皮瓣（n = 35）、腓骨皮瓣（n = 31）、髂嵴皮瓣（n = 36）、横行腹直肌肌皮瓣（n = 3）、腹股沟皮瓣（n = 1）、空肠皮瓣（n = 13）。对术后并发症的发生率及患者相关特征（年龄、性别、诊断、合并症程度、手术时长、缺损部位、放疗/化疗史）进行回顾性分析。
游离皮瓣被证明极其可靠，游离皮瓣失败率为2.9%。术后内科并发症发生率为11.4%，以心脏、肺部及感染性并发症为主。
本研究证实游离皮瓣在成功重建头颈部方面极其可靠。术后并发症的发生率与术前合并症有关。
