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August 22, 2013Head & Neck

Free flap failure in head and neck reconstruction

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Authors

CCChristian CorbittRSRoman J. SkorackiPYPeirong Yu

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Overview

Retrospective cohort study reveals high salvage success and superior functional outcomes for subsequent free flaps, suggesting repeated microvascular reconstruction is optimal.

Key Points

  • To identify causes of head and neck free flap failure and compare clinical and functional outcomes between secondary microvascular and non-microvascular salvage reconstructions.
  • Retrospectively reviewed cases of head and neck free flap loss occurring between 2000 and 2012 out of 3,090 total free flap procedures.
  • Evaluated flap success rates, speech intelligibility, and feeding tube independence in patients salvaged with either subsequent free flaps or pedicled pectoralis major flaps.
  • Flap loss occurred in 40 of 3,090 initial free flaps (1.3%), with subsequent free flap reconstruction achieving success in 27 of 28 patients (96.4%, p = 0.81 compared to the initial procedure rate).
  • For oral and pharyngeal defects, subsequent free flap salvage achieved significantly higher speech intelligibility (>80% intelligible: 100% vs. 42.9%, p = 0.01) and feeding tube independence (87.5% vs. 25.0%, p = 0.02) compared to pectoralis major flap salvage.

Cite This Study

Corbitt et al. (2013) studied this question.

synapsesocial.com/papers/6a784efede5e3adfbdf77375https://doi.org/10.1002/hed.23471
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  1. 1Complication drivers in head and neck free flap surgery: A single-center predictive analysis2026
  2. 2Personalized Strategies for Head and Neck Reconstruction Using Pedicled Flaps2026
  3. 3Complications of Free Flap Reconstruction in Maxillary and Mandibular Defects: A Systematic Review and Meta-Analysis2026 · 1 citations
  4. 4Pediatric Head & Neck Free-Flap Reconstruction Outcomes: Score-Based Effectiveness Assessment2026
  5. 5Incidence and Risk Factors for Free Flap Compromise in Head and Neck Reconstruction: A Meta‐Analysis2026