Background: Free tissue transfer is considered the gold standard in reconstruction of extensive defects in head and neck surgery.The aim of this 15-year retrospective 14-dq0051dx study is to analyze the outcomes of free tissue transfers in the head and neck area in a tertiary referral university hospital.Materials and methods: A retrospective, single-center study of all patients undergoing free tissue transfers for head and neck reconstruction between 2006 and 2020 was performed.Patient demographics, comorbidities, flap characteristics, outcomes and complications were assessed.Results: A total of 353 free flaps were performed.
The most common defect etiology was synchronous oncologic resection (74.2%).The majority of patients had at least one comorbidity (70.3%), seal cookie cutter with smoking recorded in 46.2% of the cases and alcohol consumption in 31.
7%.The anterolateral thigh flap was the most commonly used flap (37.7%), followed by the osteoseptocutaneous fibula flap (26.9%).Our overall flap success rate was 97.
7%, while the overall complication rate was 45.9%.Conclusions: Free tissue transfer in head and neck reconstruction is reliable.However, complication rates remain high due to the complexity of such cases and frequent presence of comorbidities.Nonetheless, when effectively managed within a multidisciplinary team, complications rarely jeopardize the overall reconstruction outcome.