Wang Weitao, Ong Adrian, Vincent Aurora G, Shokri Tom, Scott Britney, Ducic Yadranko
Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas.
Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York.
Semin Plast Surg. 2020 Nov;34(4):314-320. doi: 10.1055/s-0040-1721766. Epub 2020 Dec 24.
With advanced head and neck ablative surgery comes the challenge to find an ideal reconstructive option that will optimize functional and aesthetic outcomes. Contemporary microvascular reconstructive surgery with free tissue transfer has become the standard for complex head and neck reconstruction. With continued refinements in surgical techniques, larger surgical volumes, and technological advancements, free flap success rates have exceeded 95%. Despite these high success rates, postoperative flap loss is a feared complication requiring the surgeon to be aware of potential options for successful salvage. The purpose of this article is to review free flap failure and ways to optimize surgical salvage in the scenario of flap compromise.
随着先进的头颈部切除手术的出现，寻找一种能优化功能和美学效果的理想重建方案成为了一项挑战。当代采用游离组织移植的微血管重建手术已成为复杂头颈部重建的标准方法。随着手术技术的不断完善、手术量的增加以及技术的进步，游离皮瓣的成功率已超过95%。尽管成功率很高，但术后皮瓣坏死是一种令人担忧的并发症，需要外科医生了解成功挽救的潜在选择。本文的目的是回顾游离皮瓣失败的情况以及在皮瓣出现问题时优化手术挽救的方法。
