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Scapula osteocutaneous free flap reconstruction of the head and neck: Impact of flap choice on surgical and medical complications
Author(s) -
Smith Russell B.,
Henstrom Douglas K.,
Karnell Lucy H.,
Chang Kristi C.,
Goldstein David P.,
Funk Gerry F.
Publication year - 2007
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20540
Subject(s) - medicine , surgery , head and neck , scapula , free flap , complication , free flap reconstruction
Abstract Background. The scapula osteocutaneous free flap is frequently used to reconstruct complex head and neck defects given its tissue versatility. Because of minimal atherosclerotic changes in its vascular pedicle, this flap also may be used as a second choice when other osseous flaps are not available because of vascular disease at a preferred donor site. Methods. We performed a retrospective chart review evaluating flap outcome as well as surgical and medical complications based upon the flap choice. Results. The flap survival rate was 97%. The surgical complication rate was similar for the 21 first‐choice flaps (57.1%) and the 12 second‐choice flaps (41.7%; p = .481). However, patients having second‐choice flaps had a higher rate of medical complications (66.7%) than those with first‐choice flaps (28.6%; p = .066). Age and the presence of comorbidities were associated with increased medical complications. All patients with comorbidities that had a second‐choice flap experienced medical complications, with most being severe. Conclusions. The scapula osteocutaneous free flap has a high success rate in head and neck reconstruction. Surgical complications occur frequently regardless of whether the flap is used as a first or second choice. However, medical complications are more frequent and severe in patients undergoing second‐choice flaps. © 2006 Wiley Periodicals, Inc. Head Neck, 2007.