Effect of Overlapping Operations on Outcomes in Microvascular Reconstructions of the Head and Neck

Larissa Sweeny, Eben L. Rosenthal, Tyler Light, Jessica Grayson, Daniel Petrisor, Scott H. Troob, Benjamin J. Greene, William R. Carroll, Mark K. Wax

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Objective: To compare outcomes after microvascular reconstructions of head and neck defects between overlapping and nonoverlapping operations. Study Design: Retrospective cohort study. Setting: Tertiary care center. Subjects and Methods: Patients undergoing microvascular free tissue transfer operations between January 2010 and February 2015 at 2 tertiary care institutions were included (n = 1315). Patients were divided into 2 cohorts by whether the senior authors performed a single or consecutive microvascular reconstruction (nonoverlapping; n = 773, 59%) vs performing overlapping microvascular reconstructions (overlapping; n = 542, 41%). Variables reviewed were as follows: defect location, indication, T classification, surgical details, duration of the operation and hospitalization, and complications (major, minor, medical). Results: Microvascular free tissue transfers performed included radial forearm (49%, n = 639), osteocutaneous radial forearm (14%, n = 182), anterior lateral thigh (12%, n = 153), fibula (10%, n = 135), rectus abdominis (7%, n = 92), latissimus dorsi (6%, n = 78), and scapula (<1%, n = 4). The mean duration of the overlapping operations was 21 minutes longer than nonoverlapping operations (P =.003). Mean duration of hospitalization was similar for nonoverlapping (9.5 days) and overlapping (9.1 days) cohorts (P =.39). There was no difference in complication rates when stratified by overlapping (45%, n = 241) and nonoverlapping (45%, n = 344) (P =.99). Subset analysis yielded similar results when minor, major, and medical complications between groups were assessed. The overall survival rate of free tissue transfers was 96%, and this was same for overlapping (96%) and nonoverlapping (96%) operations (P =.71). Conclusions: Patients had similar complication rates and durations of hospitalization for overlapping and nonoverlapping operations.

Original languageEnglish (US)
Pages (from-to)627-635
Number of pages9
JournalOtolaryngology - Head and Neck Surgery (United States)
Issue number4
StatePublished - Apr 1 2017


  • head and neck reconstruction
  • overlapping operations
  • surgical complications

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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