Etiology and Management of Intraoperative Free Flap Failure.

Head & neck 2026

Lichtl AJ, Terry MA, Studer MB, Pipkorn P, Ducic Y, Petrisor D, Thomas CM, Kejner AE, Curry JM, Bridgham K, Jain A, Harper J, Trott S, Yang S, Taghizadeh F, Wax MK

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Abstract

[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] Retrospective review between 2010 and 2024 at 6 institutions.

[RESULTS] There were 7423 free flaps performed with 46 instances of intraoperative flap failure (0.62%). The most common recipient subsite was oral cavity (27/46, 57%). Anterolateral thigh (ALT) was the most common flap type to fail (18/46, 39%), followed by the fibula (15/46, 32%). The most common reasons for total failure were clotting without observable vessel abnormality (12/35, 34.3%), poor quality perforator (11/35, 31.4%), and vessel spasm or intimal abnormality leading to clotting (8/35, 22.9%). The most common acute management was converting to an additional free flap intraoperatively (28/46, 60.9%).

[CONCLUSIONS] Flap failure intraoperatively is rare. The majority of cases were acutely managed with an additional flap to provide defect coverage.

추출된 의학 개체 (NER)

유형영어 표현한국어 / 풀이UMLS CUI출처등장
시술 flap 피판재건술 dict 5
시술 free flap 피판재건술 dict 3

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