Free flap reconstruction following head and neck trauma

Larissa Sweeny; Anne C Kane; Carissa M Thomas; Neal Futran; Joseph M Curry; Andrés M Bur; G Nina Lu; Aishwarya Shukla; Hunter Skoog; Jaime A Pena Garcia; Angela E Alnemri; Rahul Alapati; Michael DiLeo; Andrew Fuson; Kenneth Tan; Farshid Taghizadeh; Gina D Jefferson; Daniel Petrisor; Mark K Wax

doi:10.1002/hed.27867

Free flap reconstruction following head and neck trauma

Head Neck. 2024 Jul 10. doi: 10.1002/hed.27867. Online ahead of print.

Authors

Larissa Sweeny^{1

2}, Anne C Kane³, Carissa M Thomas⁴, Neal Futran⁵, Joseph M Curry⁶, Andrés M Bur⁷, G Nina Lu⁵, Aishwarya Shukla⁵, Hunter Skoog⁴, Jaime A Pena Garcia⁴, Angela E Alnemri⁶, Rahul Alapati⁷, Michael DiLeo⁸, Andrew Fuson⁴, Kenneth Tan⁹, Farshid Taghizadeh⁹, Gina D Jefferson³, Daniel Petrisor⁹, Mark K Wax⁹

Affiliations

¹ Department of Otolaryngology - Head and Neck Surgery, University of Miami, Miami, Florida, USA.
² Surgical Care Division, Miami Veterans Affairs Health Care System, Miami, Florida, USA.
³ Department of Otolaryngology, University of Mississippi, Jackson, Mississippi, USA.
⁴ Department of Otolaryngology - Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
⁵ Department of Otolaryngology - Head and Neck Surgery, University of Washington, Seattle, Washington, USA.
⁶ Department of Otolaryngology - Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
⁷ Department of Otolaryngology - Head and Neck Surgery, University of Kansas, Kansas City, Kansas, USA.
⁸ Department of Otolaryngology, Louisiana State University Health Science Center - New Orleans, New Orleans, Louisiana, USA.
⁹ Oregon Health and Science University School of Medicine, Portland, Oregon, USA.

PMID: 38984564
DOI: 10.1002/hed.27867

Abstract

Background: Free flap (FF) reconstruction of traumatic injuries to the head and neck is uncommon.

Methods: Multi-institutional retrospective case series of patients undergoing FF reconstruction for a traumatic injury (n = 103).

Results: Majority were gunshot wounds (GSW; 85%, n = 88) and motor vehicle accidents (11%, n = 11). Majority underwent osseous reconstruction (82%, n = 84). FF failures (9%, n = 9/103) occurred in GSW patients (100%, n = 9/9) and when multiple subsites were injured (89%, n = 8/9). Preoperative antibiotics correlated with lower rates of a neck washouts (4% vs. 19%) (p = 0.01) and 30-day readmissions (4% vs. 17%) (p = 0.02).

Conclusions: All FF failures occurred in the setting of a GSW and the majority involved multiple subsites. Preoperative antibiotics correlated with lower rates of postoperative washout procedures and 30-day readmission.

Keywords: free flap; head and neck reconstruction; outcomes; trauma.