Analysis Of Clinical Factors Associated With Healing Of Free Forarm Flaps In Head And Neck Reconstruction

Objective:To analysis the factors influencing the healing of forearm free skin flap for reconstruction of the head and neck tumor resection.Methods:A total of 33 microvascular free flap procedures were performed for reconstruction of the head and neck defect from September of 2007 to March of 2011. Clinical factors influencing free flaps'survival rate were analyzed according to patients general conditions, design of flaps, recipient vessels, vessel anastomosis and postoperative radiation condition. All data was analyzed via Fisher exact probability test.Results:The success rate of flaps was 94%.27.3% of all cases suffer from postoperative complications, including partial necrosis of flap, fistula, focal infection, fission and transient nerve injury. Factors such as age, tobacco and alcohol use, diabetes, hypertension were not related to the success rates of free flaps obviously (P>0.05). Different recipient artery and vein did not significantly alter the outcome of the flaps (P >0.05).21.4% flaps (3/14) accepted postoperative radiation failed, indicating that postoperative radiation may influence the survival rate of flap.Conclusions:The present study confirms that free flaps are reliable in achieving successful reconstruction of the head and neck. Factors such as gender, age, tobacco use, drinking, diabetes and hypertension are not key points for free flap survival in head and neck reconstruction. Postoperative radiation may influence the success of flap, it is necessary to observe the color, elasticity, temperature, swelling, capillary filling. Once vascular crises happened, radiation should be stopped or adjusted.