Yannick Foerster1, Laura Baumann2, Ino Kafantari2, Manuel Olmos2, Falk Wehrhan2, Marco R Kesting2, Raimund Hm Preidl2. 1. Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, University of Erlangen-Nuremberg, Glückstraße 11, 91054, Erlangen, Germany. yannick.foerster@fau.de. 2. Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, University of Erlangen-Nuremberg, Glückstraße 11, 91054, Erlangen, Germany.
Abstract
PURPOSE: Despite microvascular free tissue transfer being the mainstay of care in the reconstruction of larger maxillofacial defects, a significant number of patients experience postoperative complications due to impaired blood supply of the flap. In this context, the early influence of recipient bed perfusion remains unclear, but there is evidence that it is associated with free flap viability immediately after surgery. METHODS: We analyzed flap and recipient bed perfusion within the first 2 weeks after surgery by using the oxygen-to-see device. One hundred ninety-one patients who underwent free flap surgery in our department were included. RESULTS: Flow parameters were higher and postoperative complications were less frequent in radial forearm free flaps compared to any other type of flap. Flow parameters of the recipient bed were higher than transferred tissue at all times, implicating flap autonomization is not completed within 2 weeks. Previous radiotherapy significantly decreased flow parameters of the recipient bed but not of the flaps. Furthermore, irradiated patients with postoperative complications were found to have reduced flow parameters of their recipient bed compared to non-irradiated patients with postoperative complications. CONCLUSION: We conclude that monitoring of recipient bed perfusion is useful for detecting flap compromise of irradiated patients in the early postoperative period.
PURPOSE: Despite microvascular free tissue transfer being the mainstay of care in the reconstruction of larger maxillofacial defects, a significant number of patients experience postoperative complications due to impaired blood supply of the flap. In this context, the early influence of recipient bed perfusion remains unclear, but there is evidence that it is associated with free flap viability immediately after surgery. METHODS: We analyzed flap and recipient bed perfusion within the first 2 weeks after surgery by using the oxygen-to-see device. One hundred ninety-one patients who underwent free flap surgery in our department were included. RESULTS: Flow parameters were higher and postoperative complications were less frequent in radial forearm free flaps compared to any other type of flap. Flow parameters of the recipient bed were higher than transferred tissue at all times, implicating flap autonomization is not completed within 2 weeks. Previous radiotherapy significantly decreased flow parameters of the recipient bed but not of the flaps. Furthermore, irradiated patients with postoperative complications were found to have reduced flow parameters of their recipient bed compared to non-irradiated patients with postoperative complications. CONCLUSION: We conclude that monitoring of recipient bed perfusion is useful for detecting flap compromise of irradiated patients in the early postoperative period.
Authors: Stefan Schultze-Mosgau; Falk Wehrhan; Gerhard Grabenbauer; Kerstin Amann; Martin Radespiel-Tröger; Friedrich Wilhelm Neukam; Franz Rodel Journal: Head Neck Date: 2002-01 Impact factor: 3.147
Authors: Stefan Schultze-Mosgau; Falk Wehrhan; Franz Rödel; Kerstin Amann; Martin Radespiel-Tröger; Gerhard G Grabenbauer Journal: Wound Repair Regen Date: 2003 Jul-Aug Impact factor: 3.617
Authors: Falk Wehrhan; Franz Rödel; Gerhard G Grabenbauer; Kerstin Amann; Wolfgang Brückl; Stefan Schultze-Mosgau Journal: Radiother Oncol Date: 2004-09 Impact factor: 6.280
Authors: Falk Wehrhan; Gerhard G Grabenbauer; Franz Rödel; Kerstin Amann; Stefan Schultze-Mosgau Journal: Strahlenther Onkol Date: 2004-08 Impact factor: 3.621