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Br J Oral Maxillofac Surg. 2019 Aug 22. pii: S0266-4356(19)30321-3. doi: 10.1016/j.bjoms.2019.08.005. [Epub ahead of print]

Results of flap reconstruction: categorisation to reflect outcomes and process in the management of head and neck defects.

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Oral and Maxillofacial Surgery, Leeds Teaching Hospitals NHS Trust, LS2 9LU, Leeds. Electronic address:
Oral and Maxillofacial Surgery, City Hospitals Sunderland NHS Foundation Trust, Sunderland.
BAOMS Quality Outcome Metrics Project Manager, British Association of Oral and Maxillofacial Surgeons, Royal College of Surgeons of England, 35/43 Lincoln's Inn Fields, WC2A 3PE, London.
Oral and Maxillofacial Surgery, Aintree University Hospitals NHS Foundation Trust, Lower Lane, Fazakerly, L9 7AL, Liverpool.
Oral and Maxillofacial Surgery, Central Manchester University Hospitals NHS Foundation Trust, Manchester.
Maxillofacial Department, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Queen Elizabeth Medical Centre, B15 2TH, Birmingham.
Oral and Maxillofacial Surgery, Queen Victoria Hospital, East Grinstead.
Oral and Maxillofacial Surgery, Guy's and St Thomas' NHS Foundation Trust, London.
Maxillofacial Unit, Queen Alexandra Hospital, PO6 3LY, Portsmouth.
National Maxillofacial Unit, St. James's Hospital, James's Street, Dublin 8, Ireland.
Oral and Maxillofacial Surgery, NHS Greater Glasgow and Clyde, Glasgow.


The reporting of the outcomes of flap reconstruction is often based on numerical success rates. Whilst this remains a useful variable with which to measure success, it is limited in its ability to reflect the complex processes involved. The lack of consistency in the categorisation of outcomes of flap reconstruction in the head and neck could potentially lead us to lose the opportunity to fully capture the implications of its success or failure, or both. We propose a classification that moves away from primarily reporting the results of its binary nature, and focuses more on the process of reconstruction, particularly in the head and neck.


Reconstruction; flap failure; flap salvage; flap survival

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