Katinka Kansy1, Andreas Albert Mueller2, Thomas Mücke3, Jean-Baptiste Kopp2, Friederike Koersgen4, Klaus Dietrich Wolff3, Hans-Florian Zeilhofer2, Frank Hölzle5, Winnie Pradel6, Matthias Schneider7, Andreas Kolk3, Ralf Smeets8, Julio Acero9, Jürgen Hoffmann4. 1. Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. Electronic address: katinka.kansy@med.uni-heidelberg.de. 2. Department of Oral and Maxillofacial Surgery, Universitätsspital Basel, University of Basel, Basel, Switzerland. 3. Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany. 4. Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. 5. Department of Oral and Maxillofacial Surgery, Aachen University Hospital, Aachen, Germany. 6. Department of Oral and Maxillofacial Surgery, Dresden University Hospital, Dresden, Germany. 7. Department of Oral and Maxillofacial Surgery, Dresden-Neustadt Hospital, Dresden, Germany. 8. Department of Oral and Maxillofacial Surgery, Hamburg University Hospital, Hamburg-Eppendorf, Germany. 9. Department of Oral and Maxillofacial Surgery, Hospital Universitario Ramón y Cajal, University of Alcala, Madrid, Spain.
Abstract
INTRODUCTION: Microvascular surgery following tumour resection has become an important field of oral maxillofacial surgery (OMFS). This paper aims to evaluate current microsurgical practice in Europe. METHODS: The questionnaire of the DOESAK collaborative group for Microsurgical Reconstruction was translated into English, transformed into an online based survey and distributed to 200 OMFS units with the aid of the European Association for Cranio-Maxillo-Facial Surgery (EACMFS). RESULTS: 65 complete and 72 incomplete questionnaires were returned. Hospitals from the United Kingdom, France, Italy, the Netherlands, Spain, Belgium, Greece, Slovenia and Lithuania participated. 71% of contributing centres were university hospitals, 87% out of these perform microvascular tumour surgery at least on a two-weekly base. Overall complication rate was at around five percent. Most frequently used transplants were the radial forearm flap and the fibular flap. The perioperative management varied widely. Success factors for flap survival, however, were uniformly rated, with the surgical skill being the most important factor, followed by the quality of postoperative management. Medication seems to play a less important role. CONCLUSION: Within Europe microvascular surgery is a common and safe procedure for maxillofacial reconstructive surgery in the field of OMFS. While there is a major accordance for the surgical procedure itself and the most frequently used flaps, perioperative management shows a wide variety of protocols with low presumed impact on surgical outcome.
INTRODUCTION: Microvascular surgery following tumour resection has become an important field of oral maxillofacial surgery (OMFS). This paper aims to evaluate current microsurgical practice in Europe. METHODS: The questionnaire of the DOESAK collaborative group for Microsurgical Reconstruction was translated into English, transformed into an online based survey and distributed to 200 OMFS units with the aid of the European Association for Cranio-Maxillo-Facial Surgery (EACMFS). RESULTS: 65 complete and 72 incomplete questionnaires were returned. Hospitals from the United Kingdom, France, Italy, the Netherlands, Spain, Belgium, Greece, Slovenia and Lithuania participated. 71% of contributing centres were university hospitals, 87% out of these perform microvascular tumour surgery at least on a two-weekly base. Overall complication rate was at around five percent. Most frequently used transplants were the radial forearm flap and the fibular flap. The perioperative management varied widely. Success factors for flap survival, however, were uniformly rated, with the surgical skill being the most important factor, followed by the quality of postoperative management. Medication seems to play a less important role. CONCLUSION: Within Europe microvascular surgery is a common and safe procedure for maxillofacial reconstructive surgery in the field of OMFS. While there is a major accordance for the surgical procedure itself and the most frequently used flaps, perioperative management shows a wide variety of protocols with low presumed impact on surgical outcome.
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