Abstract
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.
Keywords
free tissue transfer - perioperative care - head and neck reconstruction
