Perforator free flaps in head and neck reconstruction: a single-center low-volume experience

Objective The aim of this article is to investigate the results of free-flap reconstructions in the head and neck area in a secondary low-volume institution and compare these with the literature. Study Design A retrospective study was performed of all patients who underwent free-flap reconstructive surgery in our institution from January 9, 2011, to July 12, 2015, by one young surgeon in a one-team approach. The types of flaps applied, defect sites, pathology, anastomotic details, success and complication rates, lengths of stay, and patients' ages and comorbidities were analyzed. Results A total of 97 patients received 100 free flaps. Perforator flaps comprised 85% of the total (63% anterolateral thigh, 22% fibular). Thirty-six percent of free flaps were performed in patients who received previous chemotherapy radiation to the head and neck. Free-flap survival was 96%. Conclusion From our data, it seems that free-flap surgery not only is a safe and successful technique in tertiary academic hospitals, but also can be performed in smaller institutions, even in salvage situations and in patients with comorbidities. Therefore, we believe that free tissue transfer is predictable in all centers when performed by skilled microsurgeons and well-trained nursing teams.