Free Flap Outcomes of Microvascular Reconstruction after Repeated Segmental Mandibulectomy in Head and Neck Cancer Patients
Research article published in Scientific reports (2019)
Abstract
This is the first study to investigate the impact of a second fibula flap or a soft tissue flap combined with bridging plate for a repeated segmental mandibulectomy reconstruction on flap outcomes in head and neck cancer patients. A retrospective comparative analysis (2007-2016) of 61 patients who underwent a second segmental mandibulectomy was performed. 20 patients underwent a fibula flap reconstruction whereas 41 had a soft tissue flap and plate reconstruction. No significant difference was seen in the operative time, total hospital stay, flap loss, re-exploration rates, plate exposure rate, or recipient site infection rate. On multivariate analysis, patients reconstructed with a soft tissue flap and bridging plate (odds ratio (OR) 3.997; 95% confidence interval (CI), 1.046-15.280, p = 0.043) and complications developed in previous surgery (OR 4.792; 95% CI, 1.120-20.493, p = 0.035) were shown to be independent predictors of a prolonged nasogastric tube dependence. The utilization of a soft tissue flap with plate is associated with comparative results of acute complication rate within 1 week, recipient site infection rate, and plate exposure rate to free fibula flaps alone. Free fibula flaps may result in a decreased risk for prolonged tube dependence compared to free soft tissue flap reconstructions.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
A retrospective study of 61 patients undergoing repeated segmental mandibulectomy found that soft tissue flaps with bridging plates gave comparable acute complication rates to second fibula flaps, though soft tissue flaps were linked to prolonged nasogastric tube dependence.
Why This Matters for Hirudotherapy
This comparative study analyzed outcomes in 61 head and neck cancer patients undergoing repeated segmental mandibulectomy, comparing reconstruction with a second free fibula flap versus a soft tissue flap with a bridging plate. The study found no significant difference in operative time, hospital stay, flap loss, re-exploration, plate exposure, or infection rates, though soft tissue flap reconstruction was associated with higher odds of prolonged nasogastric tube dependence. The abstract reports surgical outcomes and complications. It contains no mention of leeches, hirudotherapy, venous congestion, or flap salvage techniques. Any relevance to hirudotherapy is purely indirect.
Citation
Reference (Vancouver style)
Lin JA, Loh CYY, Tsai CH, Chang KP, Wu JC, Kao HK. Free Flap Outcomes of Microvascular Reconstruction after Repeated Segmental Mandibulectomy in Head and Neck Cancer Patients. Sci Rep. 2019;9(1):7951. doi:10.1038/s41598-019-44467-x. PMID: 31138880
Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.
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