Early experience in free tissue transfer in the reconstruction of head and neck defects

Lim CM, Lim J, Loh KS, Tan LKS
Correspondence: Dr Lim Chwee Ming, limchweeming@yahoo.com.sg

ABSTRACT
Introduction This study aims to retrospectively review our early experience with free tissue transfer in the reconstruction of head and neck defects following extirpation of head and neck cancers in a tertiary hospital in Singapore.
Methods A total of 25 patients underwent free tissue transfer between June 1998 and Oct 2003. An overall descriptive analysis was carried out by looking at the following outcome measures: length of hospitalisation, duration of intensive care unit (ICU) stay, readmission for complication, and failure rate.
Results There were 21 men and four women in our study cohort, with their age ranging from 28 to 89 (mean 59.8) years. The mean length of stay was 12.6 (SD 7.3) days and mean stay in ICU was 1.6 days. Two patients (8.0 percent) were readmitted within a 30-day period after discharge for flap-related complications. Six patients (24 percent) developed flap-related complications. Two patients developed pharyngocutaneous fistula, three patients developed flap venous congestion and one patient developed minor donor site haematoma. Salvage anastomotic revision was performed in all the three congested flaps. One of the flaps was successfully revived, while the other two flaps were lost. Hence, our flap success rate was 92 percent (23/25).
Conclusion Our early experience shows that free tissue transfer is a safe surgical option in the reconstruction of head and neck defects. Our success rate is 92 percent. We believe that subsequent results would continue to improve with advances in technical skill and experience.

Keywords: free tissue transfer, head and neck cancers, reconstructive surgery
Singapore Med J 2007; 48(7): 652–655