{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:33:13Z","timestamp":1793118793744,"version":"4.5.0"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005296","name":"Universit\u00e4tsklinikum Regensburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005296","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Oral Maxillofac Surg"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Purpose<\/jats:title>\n<jats:p>Free flaps have become the standard option in reconstructive surgery of the head and neck. Even though many authors have outlined the reliability of free transplants, there is an ongoing discussion about treatment options for patients bearing particular risks as previous irradiation treatment. In this analysis, we aim to address these patients with particular risk profiles by comparing different flap entity outcome parameters.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We retrospectively analyzed a cohort of 494 patients who underwent flap surgery between 2009 and 2018 in our department. Focusing on free microvascular transplants, we additionally analyzed the pectoralis major myocutaneous flap as the most frequently used vascular pedicled flap. Data analysis was performed by uni- and multivariate statistics.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Overall flap success rate was 90%, with the radial forearm flap occurring to be most reliable (93%) in head and neck reconstruction. Previous radiation therapy (RT) and intraoperative revision of vascular anastomosis during primary surgery significantly resulted in impaired transplant outcome with a success rate of 91.8% (no RT) vs. 83.7% (RT), respectively. There was a negative linear correlation between incision to suture time and number of flaps per year (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.67).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Preoperative radiation therapy and intraoperative revision of anastomosis significantly impair outcome of microvascular flaps in the head and neck and oral cavity, whereas patient\u2019s age is not a predictor of flap failure. Increasing case number and experience reduces time of flap surgery as well as rate of complications and flap failure.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s10006-020-00838-7","type":"journal-article","created":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T09:07:55Z","timestamp":1584695275000},"page":"173-179","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["A decade of reconstructive surgery: outcome and perspectives of free tissue transfer in the head and neck. Experience of a single center institution"],"prefix":"10.1007","volume":"24","author":[{"given":"Steffen","family":"Spoerl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shlomo","family":"Schoedel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerrit","family":"Spanier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina","family":"Mueller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes K.","family":"Meier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten E.","family":"Reichert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Ettl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,20]]},"reference":[{"issue":"3","key":"838_CR1","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1002\/micr.20468","volume":"28","author":"KD Wolff","year":"2008","unstructured":"Wolff KD, Holzle F, Wysluch A, Mucke T, Kesting M (2008) Incidence and time of intraoperative vascular complications in head and neck microsurgery. Microsurgery 28(3):143\u2013146. https:\/\/doi.org\/10.1002\/micr.20468","journal-title":"Microsurgery"},{"issue":"5","key":"838_CR2","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1002\/micr.22212","volume":"34","author":"CC Wu","year":"2014","unstructured":"Wu CC, Lin PY, Chew KY, Kuo YR (2014) Free tissue transfers in head and neck reconstruction: complications, outcomes and strategies for management of flap failure: analysis of 2019 flaps in single institute. Microsurgery 34(5):339\u2013344. https:\/\/doi.org\/10.1002\/micr.22212","journal-title":"Microsurgery"},{"key":"838_CR3","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1007\/s00784-019-02914-z","volume":"24","author":"H Hanken","year":"2019","unstructured":"Hanken H, Barsukov E, Gohler F, Sehner S, Smeets R, Beck-Broichsitter B, Heiland M, Kreutzer K, Grobe A (2019) Analysis of outcome for elderly patients after microvascular flap surgery: a monocentric retrospective cohort study. Clin Oral Investig 24:193\u2013200. https:\/\/doi.org\/10.1007\/s00784-019-02914-z","journal-title":"Clin Oral Investig"},{"issue":"4","key":"838_CR4","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1002\/hed.21204","volume":"32","author":"CH Wong","year":"2010","unstructured":"Wong CH, Wei FC (2010) Anterolateral thigh flap. Head Neck 32(4):529\u2013540. https:\/\/doi.org\/10.1002\/hed.21204","journal-title":"Head Neck"},{"issue":"2","key":"838_CR5","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1016\/j.jcms.2017.11.019","volume":"46","author":"KD Wolff","year":"2018","unstructured":"Wolff KD, Rau A, Kolk A (2018) Perforator flaps from the lower leg for intraoral reconstruction: experience of 131 flaps. 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The study has been approved by the Institutional Ethical Committee (Approval No. 18-1131-104).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}