Alternative Soft Tissue Free Flaps in Multi-Flap Head and Neck Reconstruction: A Propensity Score-Matched Analysis.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 42613803.
- Also identified by DOI 10.1002/hed.70440.
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Abstract
Multi-flap reconstruction is often required for extensive head and neck defects, especially in recurrent disease, prior reconstruction, or vessel-depleted necks. While traditional donor sites remain foundational, the reliability of alternative soft tissue free flaps is less defined. This retrospective cohort study compared traditional and alternative soft tissue free flaps in multi-flap head and neck reconstruction. Outcomes were analyzed in unmatched and propensity score-matched cohorts. Primary endpoints included overall recipient site complications, flap loss, thrombosis, reoperation, and length of stay. The unmatched cohort included 171 patients and 347 flaps: 297 traditional (86%) and 50 alternative (14%). After matching, outcomes were comparable between groups. No statistically significant differences were seen in recipient site complications, reoperation, thrombosis, flap loss, or hospital stay. Alternative soft tissue free flaps appear safe and reliable when traditional workhorse flaps are unavailable.