Quantitative analysis of free flap volume changes in head and neck reconstruction

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Abstract
Background: The purpose of this study was to determine whether free flap volume decreases or increases in the long‐term postoperative period.Methods: We used a retrospective analysis of 17 patients to measure muscle and fat volume in free flap with 3‐dimensional (3D) images using the AZE Virtual Place Lexus64.Results: Seventeen patients underwent free flap reconstruction with rectus abdominis musculocutaneous flaps (n = 11) or anterolateral thigh flaps (n = 6). Median follow‐up was 28.9 months (range, 2.1–48.4 months). Total flap volume was significantly decreased in flaps including ≥40% muscle (p = .011). Mean final muscle volume was 50% at an average of 12 months. Final fat volume was significantly higher for cases with no evidence of disease (mean, 116.7%) than for died‐of‐the‐disease cases (mean, 70.3%; p = .007).Conclusion: Use of free flaps with a high ratio of fat to muscle is sustainable and can gain volume over time, as transplanted fat can increase depending on host condition. © 2011 Wiley Periodicals, Inc. Head Neck, 2011

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