Flow-Through Flaps as a Robust Method for Advanced Free Flap Reconstruction in the Head and Neck: A Multi-Institutional Experience

Eric V. Mastrolonardo; Sarah Sussman; Pablo Llerena; Dev R. Amin; Kathryn Nunes; Kelly Bridgham; Emma De Ravin; Daniel J. Campbell; Aarti Agarwal; Ramez Philips; Fahad Rind; Ryan Ivancic; Wesley McIlwain; Stephen Y. Kang; Yadranko Ducic; Larissa Sweeny; Mauricio A. Moreno; René P. Meyers; Carissa M. Thomas; Karthik Rajasekaran; Mark Wax; Joseph M. Curry; Matthew M. Hanasono

doi:10.1002/hed.28061

Flow-Through Flaps as a Robust Method for Advanced Free Flap Reconstruction in the Head and Neck: A Multi-Institutional Experience

Eric V. Mastrolonardo, Sarah Sussman, Pablo Llerena, Dev R. Amin, Kathryn Nunes, Kelly Bridgham, Emma De Ravin, Daniel J. Campbell, Aarti Agarwal, Ramez Philips, Fahad Rind, Ryan Ivancic, Wesley McIlwain, Stephen Y. Kang, Yadranko Ducic, Larissa Sweeny, Mauricio A. Moreno, René P. Meyers, Carissa M. Thomas, Karthik RajasekaranMark Wax, Joseph M. Curry, Matthew M. Hanasono

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Flow-through flaps (FTFs) are an advanced technique in which a free flap is anastomosed to the pedicle of another free flap to reconstruct extensive head and neck defects when recipient vessels are scarce. Methods: A multi-institutional cohort of FTFs used for head and neck reconstruction were reviewed. For comparison, FTF outcomes were compared to free flaps that required vein grafts (VG) to reach distant recipient vessels. Results: A total of forty-two patients underwent surgery using a FTF configuration, including 32 simultaneous and 10 sequential FTFs. There were no instances of flap failure compared to a 7% flap failure rate in the VG group (n = 54). The overall postoperative complication rate was 28% compared to a 46% complication rate in the VG group (p = 0.093). Conclusion: FTFs are a reliable option for reconstruction of extensive head and neck defects when recipient blood vessel availability is limited.

Original language	English (US)
Journal	Head and Neck
DOIs	https://doi.org/10.1002/hed.28061
State	Accepted/In press - 2025

Keywords

flow-through flap
free flap
free tissue transfer
head and neck
reconstruction

ASJC Scopus subject areas

Otorhinolaryngology

Access to Document

10.1002/hed.28061

Cite this

Mastrolonardo, E. V., Sussman, S., Llerena, P., Amin, D. R., Nunes, K., Bridgham, K., De Ravin, E., Campbell, D. J., Agarwal, A., Philips, R., Rind, F., Ivancic, R., McIlwain, W., Kang, S. Y., Ducic, Y., Sweeny, L., Moreno, M. A., Meyers, R. P., Thomas, C. M., ... Hanasono, M. M. (Accepted/In press). Flow-Through Flaps as a Robust Method for Advanced Free Flap Reconstruction in the Head and Neck: A Multi-Institutional Experience. Head and Neck. https://doi.org/10.1002/hed.28061

Mastrolonardo, EV, Sussman, S, Llerena, P, Amin, DR, Nunes, K, Bridgham, K, De Ravin, E, Campbell, DJ, Agarwal, A, Philips, R, Rind, F, Ivancic, R, McIlwain, W, Kang, SY, Ducic, Y, Sweeny, L, Moreno, MA, Meyers, RP, Thomas, CM, Rajasekaran, K, Wax, M, Curry, JM & Hanasono, MM 2025, 'Flow-Through Flaps as a Robust Method for Advanced Free Flap Reconstruction in the Head and Neck: A Multi-Institutional Experience', Head and Neck. https://doi.org/10.1002/hed.28061

@article{993c6637e89c4cefb12abb808ceb268d,

title = "Flow-Through Flaps as a Robust Method for Advanced Free Flap Reconstruction in the Head and Neck: A Multi-Institutional Experience",

abstract = "Background: Flow-through flaps (FTFs) are an advanced technique in which a free flap is anastomosed to the pedicle of another free flap to reconstruct extensive head and neck defects when recipient vessels are scarce. Methods: A multi-institutional cohort of FTFs used for head and neck reconstruction were reviewed. For comparison, FTF outcomes were compared to free flaps that required vein grafts (VG) to reach distant recipient vessels. Results: A total of forty-two patients underwent surgery using a FTF configuration, including 32 simultaneous and 10 sequential FTFs. There were no instances of flap failure compared to a 7% flap failure rate in the VG group (n = 54). The overall postoperative complication rate was 28% compared to a 46% complication rate in the VG group (p = 0.093). Conclusion: FTFs are a reliable option for reconstruction of extensive head and neck defects when recipient blood vessel availability is limited.",

keywords = "flow-through flap, free flap, free tissue transfer, head and neck, reconstruction",

author = "Mastrolonardo, {Eric V.} and Sarah Sussman and Pablo Llerena and Amin, {Dev R.} and Kathryn Nunes and Kelly Bridgham and {De Ravin}, Emma and Campbell, {Daniel J.} and Aarti Agarwal and Ramez Philips and Fahad Rind and Ryan Ivancic and Wesley McIlwain and Kang, {Stephen Y.} and Yadranko Ducic and Larissa Sweeny and Moreno, {Mauricio A.} and Meyers, {Ren{\'e} P.} and Thomas, {Carissa M.} and Karthik Rajasekaran and Mark Wax and Curry, {Joseph M.} and Hanasono, {Matthew M.}",

note = "Publisher Copyright: {\textcopyright} 2025 Wiley Periodicals LLC.",

year = "2025",

doi = "10.1002/hed.28061",

language = "English (US)",

journal = "Head and Neck",

issn = "1043-3074",

publisher = "John Wiley & Sons Inc.",

}

TY - JOUR

T1 - Flow-Through Flaps as a Robust Method for Advanced Free Flap Reconstruction in the Head and Neck

T2 - A Multi-Institutional Experience

AU - Mastrolonardo, Eric V.

AU - Sussman, Sarah

AU - Llerena, Pablo

AU - Amin, Dev R.

AU - Nunes, Kathryn

AU - Bridgham, Kelly

AU - De Ravin, Emma

AU - Campbell, Daniel J.

AU - Agarwal, Aarti

AU - Philips, Ramez

AU - Rind, Fahad

AU - Ivancic, Ryan

AU - McIlwain, Wesley

AU - Kang, Stephen Y.

AU - Ducic, Yadranko

AU - Sweeny, Larissa

AU - Moreno, Mauricio A.

AU - Meyers, René P.

AU - Thomas, Carissa M.

AU - Rajasekaran, Karthik

AU - Wax, Mark

AU - Curry, Joseph M.

AU - Hanasono, Matthew M.

PY - 2025

Y1 - 2025

N2 - Background: Flow-through flaps (FTFs) are an advanced technique in which a free flap is anastomosed to the pedicle of another free flap to reconstruct extensive head and neck defects when recipient vessels are scarce. Methods: A multi-institutional cohort of FTFs used for head and neck reconstruction were reviewed. For comparison, FTF outcomes were compared to free flaps that required vein grafts (VG) to reach distant recipient vessels. Results: A total of forty-two patients underwent surgery using a FTF configuration, including 32 simultaneous and 10 sequential FTFs. There were no instances of flap failure compared to a 7% flap failure rate in the VG group (n = 54). The overall postoperative complication rate was 28% compared to a 46% complication rate in the VG group (p = 0.093). Conclusion: FTFs are a reliable option for reconstruction of extensive head and neck defects when recipient blood vessel availability is limited.

AB - Background: Flow-through flaps (FTFs) are an advanced technique in which a free flap is anastomosed to the pedicle of another free flap to reconstruct extensive head and neck defects when recipient vessels are scarce. Methods: A multi-institutional cohort of FTFs used for head and neck reconstruction were reviewed. For comparison, FTF outcomes were compared to free flaps that required vein grafts (VG) to reach distant recipient vessels. Results: A total of forty-two patients underwent surgery using a FTF configuration, including 32 simultaneous and 10 sequential FTFs. There were no instances of flap failure compared to a 7% flap failure rate in the VG group (n = 54). The overall postoperative complication rate was 28% compared to a 46% complication rate in the VG group (p = 0.093). Conclusion: FTFs are a reliable option for reconstruction of extensive head and neck defects when recipient blood vessel availability is limited.

KW - flow-through flap

KW - free flap

KW - free tissue transfer

KW - head and neck

KW - reconstruction

UR - http://www.scopus.com/inward/record.url?scp=85214398954&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85214398954&partnerID=8YFLogxK

U2 - 10.1002/hed.28061

DO - 10.1002/hed.28061

M3 - Article

AN - SCOPUS:85214398954

SN - 1043-3074

JO - Head and Neck

JF - Head and Neck

ER -

Flow-Through Flaps as a Robust Method for Advanced Free Flap Reconstruction in the Head and Neck: A Multi-Institutional Experience

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this