Impact of radiotherapy on microsurgical reconstruction of the head and neck.

PURPOSE: To examine tissue oxygenation and perfusion of free microvascular grafts after primary reconstruction, regarding outcome for patients received adjuvant radiotherapy and different types of grafts. PATIENTS AND METHODS: Free microvascular grafts (n = 48) after primary reconstruction of the head and neck were examined for tissue oxygenation and perfusion over a period of 6 months. 28 patients received adjuvant radiotherapy. Using a laser doppler flowmetry combined with tissue spectroscopy of the Oxygen-to-see(®)--equipment (LEA Medizintechnik, Giessen), we were able to determine oxygen saturation, hemoglobin concentration, blood flow and blood flow velocity in the graft in each of two tissue depths (2, 8 mm). Different types of graft were compared. RESULT: Comparison of irradiated and non-irradiated grafts showed significant differences in tissue perfusion and oxygenation. Results for all radiated radial and fibula flaps showed no significant (p > 0.05) differences for all reviewed parameters. However, it showed no dose-volume effect with impaired functionality was found for irradiated grafts.
CONCLUSION: Mircovascular free tissue grafts show an increased perfusion and oxygenation after radiation compared to non-irradiated grafts.