Impact of radiotherapy on microsurgical reconstruction of the head and neck

Purpose To examine tissue oxygenation and perfusion of free microvascular grafts after primary reconstruction, regarding outcome for patients received adjuvant radiotherapy and different types of grafts. Patients and methods Free microvascular grafts (n - 48) after primary reconstruction of the head and neck were examined for tissue oxygenation and perfusion over a period of 6 months. 28 patients received adjuvant radiotherapy. Using a laser doppler flowmetry combined with tissue spectroscopy of the Oxygen-to-see® - equipment (LEA Medizintechnik, Giessen), we were able to determine oxygen saturation, hemoglobin concentration, blood flow and blood flow velocity in the graft in each of two tissue depths (2, 8 mm). Different types of graft were compared. Result Comparison of irradiated and non-irradiated grafts showed significant differences in tissue perfusion and oxygenation. Results for all radiated radial and fibula flaps showed no significant (p > 0.05) differences for all reviewed parameters. However, it showed no dose-volume effect with impaired functionality was found for irradiated grafts. Conclusion Mircovascular free tissue grafts show an increased perfusion and oxygenation after radiation compared to non-irradiated grafts.