Trends in free flap reconstruction of the head and neck: a single surgeon series of 1027 free tissue transfers

• DOI: 10.1111/ans.18798
• Publication Date: 2023-12-27T12:12:48Z
• Authors: Michael J. Papani...; Jonathan R. Clark
• Keywords: Reconstructive Surgeon; Perforator flaps; Fascia lata

Abstract Background Free tissue transfer has fundamentally changed head and neck surgery, enabling reliable reconstruction of large defects with better function aesthetics. This study assesses two decades trends in free flap reconstruction, how disease incidence, survival, surgeon caseload, team approach, technology have impacted practice. Methods Retrospective analysis 1027 flaps from 2006 to 2022. Outcomes examined include chronological changes selection, indication, length stay, incorporation virtual surgical planning (VSP), annual their associations the single versus multi‐team approach. Results There were 764 soft‐tissue 263 osseous reconstructions utilizing 21 different flaps. Anterolateral thigh radial forearm accounted for 76.7% soft flaps, recent increase superficial circumflex iliac perforator young patients. Osseous proportion remained stable, but fibula increased five‐fold more VSP, dental implants, oral cancer, surgery. such as complication rates, stay specific/overall survival improved over time despite increasing complexity ( P = 0.001, < respectively). However, there was no significant difference operative time, rate, or between approaches 0.45, 0.054, 0.57, 0.60, Conclusion Single may similar fundamental outcomes, complexity, life‐expectancy increases, both patients surgeons benefit a collaborative approach that focuses on improving long‐term functional outcomes.