Review
Salvage of failed free flaps used in head and neck reconstruction
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* Corresponding author: Patrick J Gullane patrick.gullane@uhn.on.ca
1 Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Hospital, and University of Toronto, Toronto, Canada
2 Department of Otolaryngology-Head and Neck Surgery, Auckland City Hospital, University of Auckland, Auckland, New Zealand
Head & Neck Oncology 2009, 1:33 doi:10.1186/1758-3284-1-33
Published: 21 August 2009Abstract
Free flap success rates are in excess of 95%. Vascular occlusion (thrombosis) remains the primary reason for flap loss, with venous thrombosis being more common than arterial occlusion. The majority of flap failures occur within the first 48 hours. With early recognition and intervention of flap compromise salvage is possible. Successful salvage rates range from 28% to over 90%. Rapid re-exploration in this clinical setting is crucial to maximise the chances of flap salvage. If salvage is not feasible or unsuccessful then non-surgical methods of salvage may be employed with some possibility of success. The purpose of this article is to review the causes of free flap failure and to highlight the available options for salvage.