Microvascular reconstruction in oral and maxillofacial surgery: a Europe-wide data collection.

[PURPOSE] This study aims to analyze microvascular reconstruction in Oral and Maxillofacial Surgery (OMFS) in Europe.

[METHODS] Based on previous studies, a dynamic online questionnaire was developed and subjected to internal and external evaluation. The questionnaire comprised multiple-choice, rating, and open-ended questions, addressing general and specific aspects and the impacts of the COVID-19 pandemic on microvascular reconstruction in OMFS in Europe. It was implemented into SurveyMonkey's online survey software and emailed to OMFS departments registered with the European Association for Cranio-Maxillofacial Surgery (EACMFS).

[RESULTS] Seventy-five participants from 23 European countries participated. Among them, 89% perform between 1 and 70 microvascular free flaps (MFF) annually. 38% of the participants reported a reduction in MFF due to the COVID-19 pandemic. The radial forearm (41% of participants) and fibula free flap (31%) are the most reported MFF. In most cases (59%), MFF procedures are exclusively performed by OMFS for OMFS patients, while 43% of participants reported cooperations with plastic surgeons to perform MFF for OMFS patients. Many participants prefer arterial end-to-end anastomoses (54%) using the facial artery (54%) and, if available, two venous anastomoses (68%). Low molecular weight heparin is the most used postoperative anticoagulant, reported by 67% of participants. For flap monitoring, clinical assessment and Doppler ultrasound are preferred by most participants (95% and 78%, respectively). Many participants (66%) indicated that tracheotomy is only performed when necessary. Differences were observed in relation to CAD/CAM (Computer-Aided Design/Computer-Aided Manufacturing) techniques, types of osteosynthesis, and dental implant treatment.

[CONCLUSION] This study highlighted variability in microvascular reconstruction in OMFS in Europe. Further studies are needed to assess these aspects in detail.