Semin Plast Surg 2019; 33(01): 005-012
DOI: 10.1055/s-0038-1676824
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Perioperative Care of Free Flap Patients

Aurora Vincent
1  Otolaryngology, Head and Neck Surgery, Madigan Army Medical Center, Tacoma, Washington
Raja Sawhney
2  Facial Plastic and Reconstructive Surgery, Otolaryngology Head and Neck Surgery, University of Florida, Gainesville, Florida
Yadranko Ducic
3  Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
08 March 2019 (online)


Microvascular free tissue transfer is an indispensable reconstructive option in head and neck reconstruction. Flap failure is relatively rare, but it is nonetheless very morbid and psychologically devastating to patients when it does occur. Further, complications after free tissue transfer to the head and neck remain common. There are numerous ongoing debates about various facets of preoperative, intraoperative, and postoperative care of patients undergoing free flap reconstruction of the head and neck, all ultimately searching for the optimal treatment algorithm to further improve flap success, minimize complications, and maximize patient outcomes. Herein, the authors review current literature surrounding optimal preoperative nutritional support, intraoperative vasopressor use, perioperative fluid management, use of antithrombotic agents, antibiotic use, and other facets of the care of head and neck free flap patients to provide a guide to surgeons.