A clinical study of microsurgical reconstruction in oral cancer. Analysis of factors related to flap necrosis

DOI 2 Citations 9 References
  • MATSUNAGA Kazuhide
    Department of Plastic and Reconstructive Surgery, Kinki University, School of Medicine Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyusyu University
  • NAGATA Tetsuji
    Department of Oral and Maxillofacial Surgery, Hamamatsu University, School of Medicine
  • ISOGAI Noritaka
    Department of Plastic and Reconstructive Surgery, Kinki University, School of Medicine
  • OOBU Kazunari
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyusyu University
  • SASAGURI Masaaki
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyusyu University
  • OHISHI Masamichi
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyusyu University

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Other Title
  • 口腔癌の血管柄付遊離皮弁再建症例における皮弁生着不良因子の検索
  • Analysis of factors related to flap necrosis

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Abstract

We studied patients who had flap necrosis after microsurgical reconstruction for orofacial defects. Among 64 patients, 5 had flap necrosis, resulting in a survival rate of 92.2%. All patients with flap necrosis underwent preoperative therapy. There was no significant difference in average age between patients with flap survival and those with flap necrosis; however, all patients with flap survival were younger than 50 years. The patients with flap necrosis had a significant decrease in postoperative pulse pressure, especially during the first and second postoperative days. Among the 5 patients with flap necrosis, 4 had a decrease in postoperative pulse pressure. Three patients concurrently had swelling in the submandibular and neck regions due to hematoma and underwent decompression procedures. On the basis of these results, we conclude that factors such as the postoperative pulse pressure and hematoma negatively affected flap blood flow.<BR>Early detection and elimination of these factors are considered essential.

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