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Current Concepts of Microvascular Reconstruction of Head and Neck Defect
摘要
Head and neck reconstruction has advanced significantly in the past two decades. There is a vast amount of literature and experience available on the various appropriate flap design and harvest technique. Currently most reconstructive surgeons are simply fine-tuning techniques to ensure complication-free reconstruction. In this paper, we review the principles of head and neck reconstruction, and present a summary of the available techniques, including our preferred algorithm to ensure a successful reconstruction. From April 2005 to December 2016, we performed 2,799 free flaps for head and neck reconstruction after tumour ablation in E-Da hospital. The free flaps included anterolateral thigh flap, radial forearm flap, and fibular osteo-cutaneous flap amongst other flaps. The success rate for free flap transfer was 97%. Oral cancer cases have an average 5-year survival rates of stage I 80.33%, stage II 78.85%, stage III 61.87% and stage IV 40.31% (2010 to 2014) in our hospital. The current surgeons should pay attention not only to the success rate of a free flap transfer but also to minimizing donor site morbidity. We propose several techniques for primary closure of the various donor sites. Finally, the flap options for recurrent cases may be limited as the available donor sites have been exhausted by previous multiple reconstruction. The free style perforator flap technique hence becomes a useful alternative.
被引用紀錄
延伸閱讀
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