Head and neck free-flap salvage

Lindsay M. Olinde, Nicole I. Farber, Joshua J. Kain

Research output: Contribution to journalReview articlepeer-review

Abstract

PURPOSE OF REVIEW: To highlight three clinical arenas in which head and neck free-flap compromise is encountered and acted upon: nonoperative, operative and postoperative realms. RECENT FINDINGS: Time to identification and intervention is paramount to successful free-flap salvage. Surgical microvascular revision remains chief amongst strategies to revert vascular compromise of a free-flap. Adjuncts, such as thrombolytics and systemic anticoagulation have an important role in the complex work of microvascular free tissue care. Venous congestion of free flaps holds favorable for salvage when compared with arterial insufficiency. SUMMARY: Vascular compromise of head and neck free flaps is a rare and feared event for microvascular surgeons, with successful transfers rates approaching above 95%. Success in salvage is dependent on prompt identification of tissue compromise and timely, directed interventions to re-establish tissue perfusion.

Original languageEnglish (US)
Pages (from-to)429-436
Number of pages8
JournalCurrent Opinion in Otolaryngology and Head and Neck Surgery
Volume29
Issue number5
DOIs
StatePublished - Oct 1 2021

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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