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Minerva Anestesiologica 2020 May 29

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


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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 optimise haematocrit 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 optimisation.


KEY WORDS: Free flap surgery; Head and neck oncological surgery; Goal directed therapy; Fluid therapy

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