The Second Time Flap from An-Already Used Donor Site in Microsurgical Head and Neck Reconstruction

• Main Authors: Nidal, Nidal F. ALDeek
• Other Authors: F. C. Wei
• Format: Others
• Language: en_US
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/y7nt6x

碩士 === 長庚大學 === 顯微手術國際碩士學位學程 === 105 === BACKGROUND: Multiple free tissue transfer from the same donor site is not well-described for microsurgical head and neck reconstruction. METHODS: Between (8/2011~11/2012), 103 patients received 103 free ALT flaps for head and neck reconstruction; flaps were called first-time ALT flaps. Intra-operative findings were used to assess the presence of a favorable anatomy for a future second flap from the same donor site. And, between 9/2009~12/2013, second-time flaps from previously-used anterior thighs were attempted either freely or guided by the intra-operative data from the previous surgery. RESULTS: A favorable anatomy for a future second-time flap was noted in (n: 96/103). Future second-time flaps were ALT, AMT, and TFL flaps (n: 32, n: 91, n: 96, respectively). The second-time flap was attempted (n: 11) and was successful (n: 8, 72.7%). Harvested second-time flaps were (5 ALT, 2 AMT, 1TFL). All flaps survived. The donor site was closed primarily (n: 6) and skin grafted (n: 2). CONCLUSION: Thorough exploration of the anatomy of the anterior thigh during the first-time ALT flap surgery with detailed documentation in addition to meticulous surgery are essential for success. The proposed concept limits morbidity to one site, and serves as an alternative donor site or a life-boat.