Free tissue transfer reconstruction of the head and neck at a veterans affairs hospital

Background. The Veterans Affairs (VA) population is considered to have generally poorer health than its non-VA counterpart. Methods. We reviewed our experience with 55 consecutive patients undergoing free tissue transfers for head and neck reconstruction at the Dallas VA Hospital between July 2000 and September 2006, with 6 months' follow-up. Results. The overall success rate was 93% (51 of 55 flaps). Factors affecting flap survival were fasciocutaneous flap versus others (p = .01) and minimal versus excessive intraoperative crystalloid administration (p = .03). Nine different flaps were used. Major and minor complications occurred in 33% (n = 18) and 31 % (n = 17) patients, respectively. Average intensive care unit and hospital stays were 7.4 and 16.0 days, respectively. Conclusions. Free flaps for head and neck reconstructions in the VA population can be performed with excellent success rates. Complication rates and hospital days in this population are similar to those of the non-VA populations. Flap selection and administration of minimal intraoperative fluids are important.