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Kliniğimizde yapılan vaskülarize serbest doku nakillerinin irdelenmes

Amaç: Serbest flep; Doku defekti çevresinden onarımın mümkün olmadığı durumlarda, vasküler pedikülü ile birlikte dokuların alıcı bölgedeki damarlara anastomozu ile transfer edilmesidir. Kliniğimizde serbest flep transferi yapılan hastalar retrospektif olarak incelenmiştir. Hastalar, cinsiyet, yaş, ilk tanıları, rekonstrüksiyon alanı, onarımda kullanılan serbest flep, hastanede kalış süresi, komplikasyonlar ve takip sonuçları açısından değerlendirilmiştir. Gereç ve yöntem: Çalışmamızda Ocak 2009-Ocak 2020 tarihleri arasında 117 hastaya 123 serbest flep ile rekonstrüksiyon yapılmıştır. 25 flep baş boyun bölgesine, 8 flep üst ekstremiteye, 59 flep alt ekstremiteye, 3 flep genital bölgeye ve 22 flep memeye transfer edilmiştir. Latissimus dorsi (31), serratus anterior (19) ve transvers rectus abdominis (18) en sık kullanılan fleplerdir. 7 hastada osteomiyelit mevcut olup enfekte kemik debridmanı sonrası serbest flep ile onarım yapılmıştır. Meme rekonstrüksiyonu için en uygun seçenek derin inferior epigastrik arter bazlı abdominal serbest fleplerdir. Bulgular: En erken taburculuk postop 6. günde olup transvers rectus abdominis serbest flebi ile meme rekonstrüksiyonu yapılan hastaya aittir. En sık karşılaşılan komplikasyon flep kenarlarında parsiyel detaşman ve nekroz olup 11 hastada izlenmiştir. Yalnızca 2 hastada dolaşım bozukluğu sebebiyle total flep nekrozu görülmüştür. Sonuç: Genel başarı oranımız flep yaşayabilirliği açısından uluslararası literatür ile uyumlu olup %97,5 olarak bulunmuştur. Kozmetik ve fonksiyonel başarılı sonuçlar, donör bölge morbiditesinin azlığı nedeniyle pediküllü fleplerin ikinci seçenek olması sonucuna ulaştırmıştır.

Examination of vascularized free tissue transfers performed in our clinic

Purpose: Free flap; is the transfer of the tissue with its vascular pedicle to the vessels in the recipient area by anastomosis, when the tissue defect cannot be repaired with its surrounding tissues. Patients who underwent free flap transfer in our clinic were analyzed retrospectively. Patients were evaluated in terms of gender, age, initial diagnosis, reconstruction area, free flap used in repair, hospitalization time, complications and follow-up results. Materials and methods: In our study 117 patients were reconstructed with 123 free flaps between January 2009 and January 2020. 25 flaps were transferred to the head and neck region, 8 flaps to the upper extremity, 59 flaps to the lower extremity, 3 flaps to the genital area and 22 flaps to the breast. Latissimus dorsi (31), serratus anterior (19) and transverse rectus abdominis (18) are the most commonly used flaps. Osteomyelitis was present in 7 patients and repair was done with free flap after infected bone debridement. The most suitable option for breast reconstruction is deep inferior epigastric artery based abdominal free flaps. Results: The earliest discharge is on the 6th postoperative day and it belongs to the patient who underwent breast reconstruction with TRAM free flap. The most common complication was partial detachment and necrosis at the flap margins, and was observed in 11 patients. Only 2 patients had total flap necrosis due to circulatory disorders. In terms of flap viability. Conclusion: Our overall success rate was found to be 97.5% in accordance with the international literatüre. Cosmetic and functional successful results have led us to conclude that pedicle flaps are the second choice due to the low donor region morbidity.

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