RESUMO

Introduction There is a current trend towards microsurgical flaps, compared with the pedicled ones in reconstruction of large locoregional defects after surgery. We reviewed the use of both techniques in head and neck reconstruction to establish the role of the non-microvascular flaps.
Materials and Methods A retrospective cross-sectional study was conducted. Statistical analysis included means and standard deviations (SD), absolute and relative frequencies, bivariate analysis correlation, and a binary logistic regression. Statistical significance was defined with p < 0.05, and 95% confidence interval (CI).
Results A total of 269 patients were reviewed, with 105 women and 164 men, and a mean age of 62.5 years. The majority had squamous cell carcinoma located in oral cavity and oropharynx, stage IV (77%). Regional flaps were used in 70.6% and microvascular in 29.4% of the cases. Overall morbidity was 16%, mortality 6.7% (all stage IV, > 70 years old). Bivariate analysis exhibited intermediate correlation between older age and greater morbidity, low correlation between advanced stages and more frequent use of microsurgical flaps, no correlation between morbidity and type of flap or clinical stage, and high correlation between over 70 years old and postoperative mortality. Logistic regression showed that microsurgical flaps had 2.8 times higher chance of morbidity and males had 2.7 times higher risk of mortality, which increasedto 18.5 times in cases with postoperative morbidity.
Conclusion Currently, even with the preference towards free flaps, pedicled ones should not be dismissed, as they can offer similar results, including lower morbidity, surgical time, and health care costs.

Palavras-chave: free-tissue flaps; head and neck neoplasms; mandibular reconstruction; microsurgery; surgical flaps