PREOPERATIVE PATIENT MANAGEMENT DURING RECONSTRUCTION WITH MICROVASCULAR FREE FLAPS: RESULTS OF THE 1ST CONSENSUS CONFERENCE OF THE ITALIAN SOCIETY OF MAXILLOFACIAL SURGERY

Aim. The use of revascularised free flaps has become increasingly important in maxillofacial surgery in recent years. Failure in reconstruction surgery phase is generally due to problems involving the microvascular anastomoses. The patency of the anastomosis is determined mainly by a proper surgical technique, though widespread use is made of devices and medical treatments with a view to increasing the success rate. Different protocols are adopted for this and for other aspects of reconstructive surgery using revascularised free flaps, based more commonly on anecdotal experiences rather than scientifically validated objective data. The authors assessed the operating methods used in this setting on a national scale, by means of a questionnaire administered to maxillofacial surgeons operating in Italy. Methods. In March 2006, the study coordinators jointly drew up 24 questions with multiple-choice answers on relevant topics to submit to review. In April 2006, the resulting questionnaire was sent by e-mail to 8 surgeons with proven experience of reconstructive microsurgery (the expert panel members). Results. The data collected were processed for use in a second stage, at a Consensus Conference held in Naples on June 30, 2006, at the time of a congress on the use of revascularised flaps in maxillofacial surgery. The investigation ascertained the opinions of numerous Italian maxillofacial surgery departments and revealed a marked diversity of approach using substantially different protocols. Conclusion. These results reflect the numerous therapeutic approaches described in the literature.