Microvascular free-tissue transfer for head and neck reconstruction in Jehovah's witness patients

Judith M. Skoner, Mark Wax

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background. Jehovah's Witnesses' religious convictions disallow blood transfusion. Major surgery in these patients is therefore problematic. The objective of this study is to describe our experience with microvascular reconstruction of complex head and neck defects in Jehovah's Witness patients. Methods. This was a retrospective review of all Jehovah's Witnesses' patients undergoing head and neck free-flap reconstruction at a tertiary academic referral center from 1997 to 2006. Results. Five Jehovah's Witnesses patients underwent a total of 7 free-flap reconstructions (6 radial, 1 rectus). Four flaps were immediate: 1 osteocutaneous radial forearm, 2 fasciocutaneous radial forearm, and 1 rectus abdominus myocutaneous. One fasciocutaneous radial forearm flap was staged. Two patients were planned secondary reconstructions, both facsciocutaneous radial forearm. Iron supplements and/or erythropoietin were administered perioperatively in 6 of the 7 microvascular reconstructions. Selective external carotid embolization was performed preoperatively in 1 patient. Hematocrit levels were 36% to 46% preoperatively and 30% to 41% postoperatively. Immediate postoperative hematocrit decline was 5.2% (3.0% to 6.0%). No transfusions or blood products were administered. Conclusions. Our case series supports the feasibility of head and neck free-flap reconstruction in these challenging patients.

Original languageEnglish (US)
Pages (from-to)455-460
Number of pages6
JournalHead and Neck
Volume30
Issue number4
DOIs
StatePublished - Apr 2008

Fingerprint

Jehovah's Witnesses
Neck
Head
Forearm
Free Tissue Flaps
Hematocrit
Blood Transfusion
Rectus Abdominis
Erythropoietin
Tertiary Care Centers
Iron

Keywords

  • Bloodless surgery
  • Free-flap reconstruction
  • Head and neck cancer
  • Jehovah's witnesses
  • Microvascular free-tissue transfer

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Microvascular free-tissue transfer for head and neck reconstruction in Jehovah's witness patients. / Skoner, Judith M.; Wax, Mark.

In: Head and Neck, Vol. 30, No. 4, 04.2008, p. 455-460.

Research output: Contribution to journalArticle

@article{07435904b9e34151aaf7ac28fa08b769,
title = "Microvascular free-tissue transfer for head and neck reconstruction in Jehovah's witness patients",
abstract = "Background. Jehovah's Witnesses' religious convictions disallow blood transfusion. Major surgery in these patients is therefore problematic. The objective of this study is to describe our experience with microvascular reconstruction of complex head and neck defects in Jehovah's Witness patients. Methods. This was a retrospective review of all Jehovah's Witnesses' patients undergoing head and neck free-flap reconstruction at a tertiary academic referral center from 1997 to 2006. Results. Five Jehovah's Witnesses patients underwent a total of 7 free-flap reconstructions (6 radial, 1 rectus). Four flaps were immediate: 1 osteocutaneous radial forearm, 2 fasciocutaneous radial forearm, and 1 rectus abdominus myocutaneous. One fasciocutaneous radial forearm flap was staged. Two patients were planned secondary reconstructions, both facsciocutaneous radial forearm. Iron supplements and/or erythropoietin were administered perioperatively in 6 of the 7 microvascular reconstructions. Selective external carotid embolization was performed preoperatively in 1 patient. Hematocrit levels were 36{\%} to 46{\%} preoperatively and 30{\%} to 41{\%} postoperatively. Immediate postoperative hematocrit decline was 5.2{\%} (3.0{\%} to 6.0{\%}). No transfusions or blood products were administered. Conclusions. Our case series supports the feasibility of head and neck free-flap reconstruction in these challenging patients.",
keywords = "Bloodless surgery, Free-flap reconstruction, Head and neck cancer, Jehovah's witnesses, Microvascular free-tissue transfer",
author = "Skoner, {Judith M.} and Mark Wax",
year = "2008",
month = "4",
doi = "10.1002/hed.20720",
language = "English (US)",
volume = "30",
pages = "455--460",
journal = "Head and Neck",
issn = "1043-3074",
publisher = "Wiley-Liss Inc.",
number = "4",

}

TY - JOUR

T1 - Microvascular free-tissue transfer for head and neck reconstruction in Jehovah's witness patients

AU - Skoner, Judith M.

AU - Wax, Mark

PY - 2008/4

Y1 - 2008/4

N2 - Background. Jehovah's Witnesses' religious convictions disallow blood transfusion. Major surgery in these patients is therefore problematic. The objective of this study is to describe our experience with microvascular reconstruction of complex head and neck defects in Jehovah's Witness patients. Methods. This was a retrospective review of all Jehovah's Witnesses' patients undergoing head and neck free-flap reconstruction at a tertiary academic referral center from 1997 to 2006. Results. Five Jehovah's Witnesses patients underwent a total of 7 free-flap reconstructions (6 radial, 1 rectus). Four flaps were immediate: 1 osteocutaneous radial forearm, 2 fasciocutaneous radial forearm, and 1 rectus abdominus myocutaneous. One fasciocutaneous radial forearm flap was staged. Two patients were planned secondary reconstructions, both facsciocutaneous radial forearm. Iron supplements and/or erythropoietin were administered perioperatively in 6 of the 7 microvascular reconstructions. Selective external carotid embolization was performed preoperatively in 1 patient. Hematocrit levels were 36% to 46% preoperatively and 30% to 41% postoperatively. Immediate postoperative hematocrit decline was 5.2% (3.0% to 6.0%). No transfusions or blood products were administered. Conclusions. Our case series supports the feasibility of head and neck free-flap reconstruction in these challenging patients.

AB - Background. Jehovah's Witnesses' religious convictions disallow blood transfusion. Major surgery in these patients is therefore problematic. The objective of this study is to describe our experience with microvascular reconstruction of complex head and neck defects in Jehovah's Witness patients. Methods. This was a retrospective review of all Jehovah's Witnesses' patients undergoing head and neck free-flap reconstruction at a tertiary academic referral center from 1997 to 2006. Results. Five Jehovah's Witnesses patients underwent a total of 7 free-flap reconstructions (6 radial, 1 rectus). Four flaps were immediate: 1 osteocutaneous radial forearm, 2 fasciocutaneous radial forearm, and 1 rectus abdominus myocutaneous. One fasciocutaneous radial forearm flap was staged. Two patients were planned secondary reconstructions, both facsciocutaneous radial forearm. Iron supplements and/or erythropoietin were administered perioperatively in 6 of the 7 microvascular reconstructions. Selective external carotid embolization was performed preoperatively in 1 patient. Hematocrit levels were 36% to 46% preoperatively and 30% to 41% postoperatively. Immediate postoperative hematocrit decline was 5.2% (3.0% to 6.0%). No transfusions or blood products were administered. Conclusions. Our case series supports the feasibility of head and neck free-flap reconstruction in these challenging patients.

KW - Bloodless surgery

KW - Free-flap reconstruction

KW - Head and neck cancer

KW - Jehovah's witnesses

KW - Microvascular free-tissue transfer

UR - http://www.scopus.com/inward/record.url?scp=42549167889&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=42549167889&partnerID=8YFLogxK

U2 - 10.1002/hed.20720

DO - 10.1002/hed.20720

M3 - Article

C2 - 18098311

AN - SCOPUS:42549167889

VL - 30

SP - 455

EP - 460

JO - Head and Neck

JF - Head and Neck

SN - 1043-3074

IS - 4

ER -