We performed a retrospective chart review of a tertiary care medical center. Our objective was to report our experience with microvascular reconstruction in the head and neck in @entity1 who presented with radiation-induced @entity3145 . We will discuss the effects of radiation to soft tissues and bone in the head and neck as well as the challenges it presents for later free tissue transfer. @entity1 were identified who underwent free tissue transfer to the head and neck for radiation-induced tissue injury by the senior author at our institution. Data were collected to include location of the @entity66 , radiation amount and zone of @entity1161 , initial surgical reconstruction, time to development of radiation @entity39 , type of free flap selected, recipient vessel selection, the number of sequential free tissue transfers, hyperbaric @entity26 therapy, flap success rates, and minor complications. @entity1 were excluded if recurrent @entity5 was identified at any time following reconstruction. One hundred sixty-one free flaps were performed from 2000 to 2004 in the head and neck by the senior author at our tertiary care institution. Fourteen @entity1 were identified who met the inclusion criteria and 16 (two lateral thigh, two iliac crest, one radial forearm, one transverse rectus abdominis, six fibula, two latissimus dorsi with associated rib, and two scapula) free flaps were performed for radiation-induced complications. Five @entity1 required multiple sequential free flaps including the initial reconstruction. Anastomosis was performed within the radiation zone of injury in 14 cases (87.5%), whereas 2 (12.5%) were performed outside the zone of injury. Forty-three percent of @entity1 ( N = 6) underwent hyperbaric @entity26 therapy. After initial reconstruction, the incidence of complications requiring surgical intervention included skin breakdown ( N = 1), @entity292 ( N = 2), and persistent @entity7190 ( N = 2). The mean time to follow-up was 17.5 months (range 1 to 49). There was one partial flap failure that was salvaged by thrombectomy. There were no @entity177 . As primary treatment for @entity135 moves toward radiation therapy, microsurgical reconstruction is playing an increasing role for those @entity1 developing radiation-related complications. Radionecrosis is a progressive disease where the incidence is increasing as @entity1 are surviving longer. Understanding the effects of radiation on soft tissue and bone and the complexity of reconstruction in the zone of injury will greatly improve the success of reconstruction.

Microsurgical reconstruction for radiation XXXX : an evolving disease.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity135 :: ('MESH:D006258', 'Disease') :: ['head and neck cancer'] @entity66 :: ('MESH:D004194', 'Disease') :: ['primary disease'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis'] @entity1161 :: ('MESH:D011832', 'Disease') :: ['radiation injury'] @entity3145 :: ('MESH:D017695', 'Disease') :: ['tissue damage'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity7190 :: ('MESH:D010025', 'Disease') :: ['osteoradionecrosis'] @entity177 :: ('MESH:D051437', 'Disease') :: ['total flap failures'] @entity292 :: ('MESH:D005402', 'Disease') :: ['fistula']
@entity39 :: (MESH:D009336,Disease) :: ['necrosis']
