Wax MK

[OBJECTIVE] Second victim syndrome (SVS) is when a health care provider involved in a patient complication is traumatized by the event, manifesting as symptoms of anxiety, depression, and shame. We investigated microvascular surgeons' emoti…

[BACKGROUND] Intraoperative free flap failure necessitates prompt intraoperative decision-making on alternative reconstructive strategies. In this study, we investigate the etiology and management of intraoperative flap loss. [METHODS] Ret…

[BACKGROUND] The scapula free flap is an unpopular option for osseous reconstruction of the head and neck in part due to the inability to perform simultaneous ablative surgery and harvesting of the free flap. In addition, it was originally …

Donor site morbidity has become a major focus in free tissue transfer as flap success rates have approached 98%. Emphasis is placed on minimizing the morbidity and optimizing cosmetic and functional outcomes at the donor site. This article …

Facial paralysis severely impacts a person's ability to interact with the world. Advances in microsurgery, especially free neurotized muscle transfers, have greatly improved reanimation outcomes. The gracilis free muscle transfer, introduce…

[OBJECTIVES] Virtual surgical planning (VSP) allows for optimal reconstruction of maxillary defects with fibula free flaps. Current data are limited regarding long-term complications of patient-specific plates (PSPs) in this setting. Our ob…

[OBJECTIVE] Microvascular free flap reconstruction for head and neck defects carries a 95% success rate. When flap compromise occurs, it is often due to vascular occlusion. This study seeks to determine what impact lovenox prophylaxis has o…

[OBJECTIVE] Late free flap failure is an unusual setback for patients; we investigated the etiology and management of late flap failure. [STUDY DESIGN] Single-institution retrospective review of 1959 free flaps from 2010 to 2023 for head a…

[BACKGROUND] The arteriovenous (AV) loop is a versatile and reliable technique for establishing vascular access in head and neck free tissue reconstruction. This method is particularly advantageous in complex cases where conventional vascul…

[OBJECTIVE] The "July effect," a theory that the beginning of the academic year has worse operative outcomes and complication rates, remains controversial. We evaluated the "July effect" as a risk factor for negative operative outcomes in h…

[BACKGROUND] In patients with acquired maxillary defects, obturators are often effective, but some fail, necessitating further surgery, typically via free flap reconstruction. Long-term functional outcomes in these cases are underreported. …

[OBJECTIVES] Microvascular free tissue transfer is routinely used for reconstructing midface defects in patients with malignancy, however, studies regarding reconstructive outcomes in invasive fungal sinusitis (IFS) are lacking. We aim to d…

[BACKGROUND] Medication related osteonecrosis of the jaw (MRONJ) requiring free flap (FF) reconstruction is uncommon with limited reported findings. [METHODS] Multicenter, retrospective case series of 49 consecutive adult patients presenti…

[INTRODUCTION] Coronavirus disease 2019 (COVID-19) affects the vascular system, subjecting patients to a hypercoagulable state. This is of particular concern for the success of microvascular free flap reconstruction. This study aims to repo…

[BACKGROUND] Head and neck osteoradionecrosis (ORN) of the midface requiring free flap (FF) reconstruction is uncommon. This multi-institutional study was designed to review outcomes for this rare patient population. [METHODS] Retrospectiv…

[INTRODUCTION] Cervical spine defects result in spinal instability, putting the spinal cord and vertebral arteries at risk of damage and possibly devastating neurological injuries. The fibula free flap can span the spinal defects for stabil…

[BACKGROUND] Free flap (FF) reconstruction of traumatic injuries to the head and neck is uncommon. [METHODS] Multi-institutional retrospective case series of patients undergoing FF reconstruction for a traumatic injury (n = 103). [RESULTS…

[OBJECTIVE] Assess the long-term plate complications with patient-specific plates (PSPs) created with computer-aided design (CAD) and computer-aided manufacturing (CAM) for fibula free flap reconstructions for mandibular defects. [METHODS]…

[OBJECTIVE] Determine which variables impact postoperative discharge destination following head and neck microvascular free flap reconstruction. [STUDY DESIGN] Retrospective review of prospectively collected databases. [METHODS] Consecuti…

[BACKGROUND] Few standardized methods exist for evaluating the postoperative outcomes of osteocutaneous free flaps. We propose an anatomic-based scoring system for midface free flap reconstruction. [METHODS] One hundred and twelve patients…

[EDUCATIONAL OBJECTIVE] Assess outcomes of pediatric facial reconstruction with fibula free flaps. [OBJECTIVES] Free flap reconstruction of complex maxillofacial defects in pediatric patients is rare. Post-operative complications, donor si…

Free tissue transfer has become the reconstructive modality of choice for replacing composite tissue defects. While the success rate in high-volume centers is reported to be greater than 95%, up to 10% of patients will require revision of t…

[OBJECTIVE(S)] Patients with intracranial tumors have a higher risk of thromboembolic events. This risk increases at the time of surgical intervention. We have noted an anecdotal increase in perioperative flap thrombosis in patients undergo…

Head and neck free flap survival relies on adequate tissue perfusion from the external carotid artery (ECA), and vessel length is inversely proportional to blood flow rate. Investigate whether distance from the ECA (as a proxy for pedicle …

[OBJECTIVES] Highlight the use of fluorescent angiography in free flap reconstruction of the head and neck. Qualify how fluorescent angiography can be selectively added to management paradigms for head and neck free flap reconstruction. [M…

[OBJECTIVES] The rectus abdominis myocutaneous free flap has been widely used as a reconstructive option in head and neck reconstruction with great success. Challenging the popular assumption, this study sought to examine the effects of smo…

[OBJECTIVES] Iatrogenic injury of the fibula free flap pedicle is rare. Postoperative flap survival and reconstructive outcomes following intraoperative pedicle severance are unknown. This study assesses free flap outcomes following acciden…

The implantable arterial doppler (IAD) is frequently used to postoperatively monitor free flaps with high accuracy, but there are no guidelines for its use. Bedside exam is used adjunctively to determine necessary intervention. This systema…

[BACKGROUND] Complex scalp wounds with cranial/dural involvement are challenging to reconstruct. Successful reconstruction can be achieved with cranial implants/hardware and free flap coverage. Wounds can breakdown and require revision proc…

[OBJECTIVE] To determine whether gender differences exist in the training history, practice patterns, and home lives of surgeons who perform microvascular reconstruction of the head and neck. [STUDY DESIGN] Cross-sectional survey. [SETTIN…