The old and ill: influence and impact on the reconstructive effort.

Head and neck reconstruction is often mandatory in elderly and ill patients, especially after tumor ablation. Even complex reconstructive procedures can be done in the elderly population after careful evaluation. The morbidity and mortality rates increase with age, thus the risks and benefits of surgical intervention must be weighed precisely. The functional capacities of the vital organs and the limitations should be assessed. The only significant preoperative guide for the risk of the operation is the American Society of Anesthesiologists (ASA) score. According to this scoring system, ASA 3 and 4 patients are more prone to complications. For a successful reconstructive procedure in old and ill patients, detailed preoperative evaluation is mandatory. Based on this evaluation, the type and duration of the surgery can be properly selected, and postoperative monitoring can be handled individually.