Abstract
Microsurgical procedures for reconstruction after resection of head and neck tumours
have become standardised and reliable. Among them, the scapular free flap is used
less often, mostly to avoid excessive operating times. We hypothesise that complex
reconstructions after resection of oral squamous cell carcinoma (OSCC) are successful
even with time-consuming free flaps such as the scapular free flap. In this retrospective,
single-centre study, we used the evaluation of medical records to investigate the
postoperative outcome of microvascular reconstruction after ablative surgery of OSCC.
Associations among the categorical variables were analysed using Pearson’s chi squared
test or Fisher’s exact test. Among the continuous variables, the t test or Mann-Whitney U test were used as appropriate. For multivariate analysis,
the logistic regression model was calculated. In the sample of 280 free flap reconstructions,
we performed 142 radial forearm and 119 scapular free flaps. The American Society
of Anesthesiology (ASA) score (p = 0.006) and the duration of the operation (p = 0.010) are independent factors which influence the need for operative revisions. The
type of free flap is irrelevant for that. With 4.2% flap losses, scapular free flaps
were successful; even in patients ≥ 70 years old (0 flap losses). Complex reconstructions
after surgical resection of OSCC are successful even in aged patients. The scapular
free flap is a good choice for mandibular reconstruction despite the time-consuming
intraoperative repositioning of the patient. In an increasingly ageing group of patients,
who have more vascular diseases, scapular free flaps could be a very successful alternative
after ablative surgery of oral squamous cell carcinoma.
Keywords
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Article info
Publication history
Published online: March 19, 2020
Accepted:
February 25,
2020
Received:
September 15,
2019
Identification
Copyright
© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
