Outcomes of microvascular flap reconstruction of the head and neck in patients receiving systemic immunosuppressive therapy for organ transplantation

2018 ◽  
Vol 117 (7) ◽  
pp. 1575-1583 ◽  
Author(s):  
Mark V. Schaverien ◽  
Riley A. Dean ◽  
Jeffrey N. Myers ◽  
Lin Fang ◽  
Rene D. Largo ◽  
...  
Keyword(s):  
Head And Neck ◽  
Immunosuppressive Therapy ◽  
Organ Transplantation ◽  
Flap Reconstruction ◽  
Microvascular Flap

Factors Affecting Cancer Recurrence after Microvascular Flap Reconstruction of the Head and Neck

2005 ◽  
Vol 115 (8) ◽  
pp. 1391-1394 ◽  
Author(s):  
Jason Roostaeian ◽  
Jeffrey D. Suh ◽  
Joel A. Sercarz ◽  
Elliot Abemayor ◽  
Jivianne T. Lee ◽  
...  
Keyword(s):  
Head And Neck ◽  
Cancer Recurrence ◽  
Flap Reconstruction ◽  
Factors Affecting ◽  
Microvascular Flap

Microvascular Flap Reconstruction for Head and Neck Cancers in Previously Operated and/or Radiated Neck

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Vinay K. Shankhdhar ◽  
Mayur R. Mantri ◽  
Snehjeet Wagh ◽  
Shivakumar Thiagarajan ◽  
Devendra Chaukar ◽  
...  
Keyword(s):  
Head And Neck ◽  
Head And Neck Cancers ◽  
Flap Reconstruction ◽  
Microvascular Flap

Microvascular Flap Reconstruction of the Head and Neck

1983 ◽  
Vol 10 (1) ◽  
pp. 73-83
Author(s):  
Stephen R. Colen ◽  
Daniel C. Baker ◽  
William W. Shaw
Keyword(s):  
Head And Neck ◽  
Flap Reconstruction ◽  
Microvascular Flap

Craniectomy with microvascular flap reconstruction in a patient taking infliximab for vasculitis

2020 ◽  
Vol 13 (12) ◽  
pp. e238614
Author(s):  
Ogonna N Nnamani Silva ◽  
Audrey B Nguyen ◽  
William Y Hoffman
Keyword(s):  
Diabetes Mellitus ◽  
Latissimus Dorsi ◽  
Perioperative Management ◽  
Large Cell ◽  
Evidence Based ◽  
Flap Reconstruction ◽  
Biologic Drugs ◽  
Temporal Arteries ◽  
Immune Mediated ◽  
Microvascular Flap

For patients whose vasculitis is managed with biologic medications, no reports or evidence-based guidance exists regarding the perioperative management of microvascular flaps. We present a case of a 78-year-old patient with Takayasu’s arteritis (TA) and diabetes mellitus who was taking infliximab and underwent wide local excision of squamous cell carcinoma, craniectomy and reconstruction with a latissimus dorsi flap. TA, an immune-mediated large cell vasculitis characterised by granuloma formation, tends to affect larger vessels and aortic branches. The typical localisation of this condition raises concerns about potentially compromised pedicle and recipient vessels (ie, superficial temporal arteries), which could hinder postoperative flap success. Discontinuation of infliximab 4 weeks before surgery and resumption 6 weeks after led to favourable results. This case addresses the gap in the literature concerning stopping and restarting biologic drugs in the perioperative setting and documents a successful course of a microvascular procedure in a patient with vasculitis.

Frequent omission of radiation after flap reconstruction of head and neck cancer: Are we dooming patients to failure?

Oral Oncology ◽  
2021 ◽  
pp. 105225
Author(s):  
Lauren M. North ◽  
Erin Harvey ◽  
Brigitte Vanle ◽  
Aditya Shreenivas ◽  
Monica Shukla ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Flap Reconstruction

Free Flap Reconstruction in the Head and Neck. Indications, Technical Aspects and Outcomes

2014 ◽  
Vol 65 (1) ◽  
pp. 33-42
Author(s):  
José Luis Llorente ◽  
Fernando López ◽  
Vanessa Suárez ◽  
Ángel Fueyo ◽  
Susana Carnero ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Technical Aspects

scholarly journals Factors increasing the risk of flap complications following pectoralis major myocutaneous flap reconstruction for head and neck cancers

2020 ◽  
Vol 6 (6) ◽  
pp. 1138
Author(s):  
Subbiah Shanmugam ◽  
Syed Afroze Hussain ◽  
Rajiv Michael
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Radiation Treatment ◽  
Demographic Data ◽  
Major Complication ◽  
Pectoralis Major ◽  
Head And Neck Reconstruction ◽  
Complication Rates ◽  
Flap Reconstruction ◽  
Operative Care

<p class="abstract"><strong>Background:</strong> Oral cavity cancer is one of the most common cancers and a leading cause of cancer death in India. Pectoralis major myocutaneous flaps (PMMC) are still widely used for reconstruction of defects in the head and neck, though microvascular free flaps are the ‘gold standard’. This study was aimed to identify the risk factors involved in increasing the post-operative PMMC flap complications.</p><p class="abstract"><strong>Methods:</strong> Patients who underwent surgical resection of primary head and neck cancer with PMMC flap reconstruction were included and their demographic data, pre-operative laboratory values, surgery details and post-operative flap morbidity were collected retrospectively from the master case sheets from January 2013 to December 2019. Factors such as age, gender, stage of disease, pre-operative anemia, hypoprotenemia and radiation therapy, presence of diabetes and size of the flaps were analysed to find their relation in causing flap complications.  </p><p class="abstract"><strong>Results:</strong> Totally 285 patients were included for analysis and 9.82% (n=28) had major flap complications. On analysis we found that pre-operative hypoproteinemia (serum albumin &lt;3.5) (p=0.001) and prior radiation therapy (p=0.02) significantly increased the risk of flap complications. Similarly, patients with larger bipaddled flaps had higher flap complication rates (p=0.0002) and previous radiation treatment further increased the major complication rates in bipaddle flaps.</p><p class="abstract"><strong>Conclusions:</strong> PMMC flaps are still a viable option for head and neck reconstruction especially in patients with multiple comorbidities and where free microvascular flaps are not done routinely. Careful patient selection, pre-operative optimisation and good post-operative care will help to reduce flap complications.</p><p> </p>

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