Reconstruction of the head and neck with free osteoseptocutaneous flap in elderly heavy smokers

Yıl 2008, Cilt: 18 Sayı: 2, 61 - 65, 18.04.2008

Samet Vasfi Kuvat Atakan Aydın Günter Hafız İsmet Aslan Emre Hocaoğlu Ahmet Biçer Bülent Yaprak Hayri Ömer Berköz

Öz

Objectives: We evaluated complications of free flap reconstruction following oncological head and neck surgery in elderly patients who smoked heavily. Patients and Methods: The study included eight patients 2 females, 6 males; mean age 68.5 years; range 65 to 74 years over 65 years of age, who smoked heavily at least 1 pack/day . All cases but one with mandibular ameloblastoma had intraoral squamous cell carcinoma. Two patients underwent reconstruction with free radial forearm osteoseptocutaneous flap following bilateral maxillary resection, and six patients with free fibular osteoseptocutaneous flap following mandibular resection. Postoperative complications, in particular those associated with the donor and recipient sites were evaluated. Results: No partial or total flap loss was observed. Wound healing problems were seen in three patients 37% , which were at the donor site in two patients, and at the recipient site in one patient. Psychogenic disorders were observed in two patients 25% . No other complications were encountered. Conclusion: Aside from some recipient- and donorsite-related healing problems, heavy smoking and advanced age cannot be regarded as contraindications for free flap reconstruction.

Anahtar Kelimeler

Reconstructive surgical procedures, smoking/ adverse effects, risk factors, surgical flaps, wound healing

Ağır sigara içici yaşlı hastaların baş-boyun rekonstrüksiyonunda serbest osteoseptokutan flep uygulamaları

Öz

Amaç: Bu çalışmada, ağır sigara içici yaşlı hastalarda onkolojik baş-boyun cerrahisi sonrası gelişebilecek serbest flep komplikasyonları araştırıldı.Hastalar ve Yöntemler: Çalışmaya, 65 yaş üstü, ağır sigara içici en az 1 paket/gün sekiz hasta alındı. Hastalardan biri mandibüler ameloblastom, yedisi ağız içi yerleşimli skuamöz hücreli karsinom nedeniyle ameliyat edildi. İki hastaya iki taraflı maksiller rezeksiyon sonrası serbest radial önkol osteoseptokutan flep, altı hastaya mandibüler rezeksiyon sonrası serbest fibular osteoseptokutan flep uygulandı. Tüm olgular, alıcı ve verici sahadaki komplikasyonlar ile genel tıbbi komplikasyonlar açısından incelendi.Bulgular: Hiçbir hastada kısmi ya da tam flep kaybı görülmedi. Üç hastada %37 yara iyileşmesi komplikasyonu gelişti; bu komplikasyonların ikisi verici sahada, biri alıcı sahada idi. İki hastada %25 psikojenik sorunlar görüldü. Bunun dışında genel tıbbi komplikasyonlara rastlanmadı.Sonuç: Alıcı ve verici sahada oluşabilecek komplikasyonlara rağmen, ağır sigara içimi ve ileri yaş serbest flep uygulamaları açısından kontrendikasyon olarak görülmemelidir

Anahtar Kelimeler

Rekonstrüktif cerrahi işlem, sigara içme/yan etki, risk faktörü, cerrahi flep, yara iyileşmesi

Kaynakça

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