This is a retrospective analysis from China of 881 free flaps over nearly four years, 49 of which were ‘taken back’, 26 of which were lost, giving a 97% success rate. The commonest cause of flap failure was venous thrombosis. The commonest cause of take-back that proved to be successful was haematoma. Free flaps with arterial concern tended to suffer worse outcomes than flaps with venous thrombosis. A history of irradiation was a statistically significant factor for free flap failure. Amongst others factors, age and previous neck surgery were not associated with adverse flat outcomes.

Risks of free flap failure, a retrospective analysis of 881 free flap head and neck defect reconstruction.
Zhou W, Zhang WB, Yu Y, et al.
INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY
2017;46:941-5
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Stuart Clark

Manchester Royal Infirmary, Manchester, UK.

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