American Society of Hirudotherapy

Head and Neck Tumor Resection and Free Flap Reconstruction in Low-Volume Center

Observational published in Ear Nose Throat J (2020)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportClinical TrialsSafety & Infection ControlBrennan M et al. · Ear, nose, & throat journal, 2020

Abstract

OBJECTIVE: To determine the surgical outcomes of free tissue transfer surgery following head and neck tumor extirpation in a low-volume medical center. METHODS: Retrospective chart review of patients who underwent free tissue transfer surgery for head and neck cancer at Moanalua Medical Center from 2015 to 2018. MAIN OUTCOME OF MEASURE: Free flap failure rate and free flap-related complications. RESULTS: From 2015 to 2018, there were 27 free tissue transfer surgery (mean 6.75 flap surgery/year). There were 2 events of partial flap necrosis, and no cases of total flap loss. One patient required leech therapy for venous congestion. One patient required additional free flap surgery. Two patients developed orocutaneous fistula that resolved with local wound care. One patient developed malocclusion following mandible reconstruction using fibular free flap. Overall free flap success rate was 96%. CONCLUSION: This study supports the ability of small-volume centers to produce positive outcomes with few complications in head and neck cancer free flap reconstructive surgery. While the data are limited to a single surgical team in one care center, it provides additional support for the idea that there are factors beyond the surgical volume that determine outcome.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal Article
Indexed MeSH termsFree Tissue FlapsHead and Neck NeoplasmsHospitals, Low-VolumeHumansPostoperative ComplicationsPlastic Surgery ProceduresRetrospective StudiesTreatment Outcome

Summary

Retrospective series of 27 free-flap reconstructions for head and neck cancer at a low-volume center (mean 6.75 flaps/year). One patient required leech therapy for venous congestion; overall 96% free-flap success.

Why This Matters for Hirudotherapy

This retrospective chart review examined surgical outcomes of free tissue transfer following head and neck tumor resection at a single low-volume center (Moanalua Medical Center, 2015-2018), reporting a 96% free flap success rate across 27 cases. Notably, one patient required leech therapy for venous congestion, directly situating hirudotherapy within the reconstructive surgery complication-management armamentarium. For ASH's domain, this reinforces the established role of medicinal leeches as a salvage tool for venous congestion in free flap surgery, even in low-volume settings. The caveat is that leech therapy is mentioned only as a single clinical event without detail on technique, duration, or outcome specific to leeching; the study's primary focus is surgical volume-outcome relationships, not hirudotherapy efficacy.

Citation

Head and Neck Tumor Resection and Free Flap Reconstruction in Low-Volume Center.

Brennan M et al. · Ear, nose, & throat journal, 2020

DOI

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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