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Minerva Anestesiologica 2020 August;86(8):861-71

DOI: 10.23736/S0375-9393.20.13997-X

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

New techniques and recommendations in the management of free flap surgery for head and neck defects in cancer patients

Blanca TAPIA 1 , Elena GARRIDO 2, Jose L. CEBRIAN 3, Jose L. del CASTILLO 3, Estibaliz ALSINA 1, Fernando GILSANZ 1

1 Department of Anesthesia and Intensive Care, La Paz University Hospital, Madrid, Spain; 2 Department of Anesthesia an Intensive Care, Wexner Medical Center, Columbus, OH, USA; 3 Department of Oral and Maxillofacial Surgery, La Paz University Hospital, Madrid, Spain



Free flap surgery is the gold standard surgical treatment for head and neck defects in cancer patients. Outcomes have improved considerably, probably due to recent advances in surgical techniques. In this article, we review improvements in the parameters traditionally used to optimize hematocrit levels and body temperature and to prevent vasoconstriction, and describe the use of cardiac output-guided fluid management, a technique that has proved useful in other procedures. Finally, we review other parameters used in free flap surgery, such as clotting/platelet management and nutritional optimization.


KEY WORDS: Free tissue flaps; Surgical flaps; Head and neck neoplasms; Early goal-directed therapy; Fluid therapy

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