Xiong Yu, Xu Zepeng, Ainiwaer Mailudan, Jiang Zheng, Chen Fei
Sichuan University, West China Hospital, Department of Otolaryngology, Head and Neck Surgery, Chengdu, China; Sichuan University, West China Hospital, Head and Neck Surgical Center, Chengdu, China.
West China Clinical Medical College of Sichuan University, Chengdu, China.
Braz J Otorhinolaryngol. 2025 Jul 29;91(6):101693. doi: 10.1016/j.bjorl.2025.101693.
For patients with Head and Neck Cancer (HNC), flap reconstruction is one of the treatment modalities for large head and neck defects. While most patients achieve satisfactory outcomes with a single flap, some may require a second or additional flaps due to various reasons. The aim of our study was to systematically review the relevant articles and investigate the application of sequential flaps in reconstruction of patients with HNC.
Two authors independently screened articles from PubMed, EBSCO, and Web of Science. Studies were included if they reported at least one of the following outcomes: duration of operation or hospitalization, flap-related postoperative complications, flap success rate, and follow-up outcomes.
A total of 17 articles were included, comprising 832 patients and 1037 flaps (excluding the number of flaps used in initial reconstructions). The overall flap failure rate was 5.4%. Among the 314 flap-related postoperative complications, the most common were revision (5.8%), complete flap necrosis (5.2%), and arterial or venous thrombosis (3.3%).
Sequential flaps are an optional and effective reconstructive modality for HNC patients. However, prospective studies are needed to explore prognostic-related risk factors and better determine the suitability of sequential flaps for individual patients. Additionally, since reconstruction impacts both aesthetics and function, it is crucial to emphasize during preoperative discussions that postoperative outcomes may not fully align with patient expectations.
对于头颈部癌（HNC）患者，皮瓣重建是治疗大型头颈部缺损的治疗方式之一。虽然大多数患者使用单个皮瓣就能取得满意的效果，但由于各种原因，一些患者可能需要第二个或额外的皮瓣。我们研究的目的是系统回顾相关文章，并调查序贯皮瓣在HNC患者重建中的应用。
两位作者独立从PubMed、EBSCO和Web of Science筛选文章。如果研究报告了以下至少一项结果，则纳入研究：手术或住院时间、皮瓣相关术后并发症、皮瓣成功率和随访结果。
共纳入17篇文章，包括832例患者和1037个皮瓣（不包括初次重建中使用的皮瓣数量）。皮瓣总体失败率为5.4%。在314例皮瓣相关术后并发症中，最常见的是修复（5.8%）、皮瓣完全坏死（5.2%）以及动脉或静脉血栓形成（3.3%）。
序贯皮瓣是HNC患者一种可选且有效的重建方式。然而，需要进行前瞻性研究以探索与预后相关的风险因素，并更好地确定序贯皮瓣对个体患者的适用性。此外，由于重建会影响美观和功能，在术前讨论中强调术后结果可能不完全符合患者期望至关重要。
