micro anastomosis?

[rigid]

I have read a lot that ENT do their own free flaps for H+N cases, however was wondering if they are actually trained in micro-vascular anastomosis as well or do they have to call in a plastics guy for that?

Sorry if its been repeated but i did a search and couldn't find a thread on it

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[rmm262002]

The ones that do free flaps typically have done fellowships (either H&N or FPRS) that include microvascular training and thus, they do their own anastamoses. Some H&N surgeons do use general plastics people for their recons, though. It's institution-dependent.

 

[OtoHNS]

The trend over the past 10 years has been more and more ENT departments hiring ENT-trained microvascular surgeons and doing their own flaps. When I applied for residency in 2004-05, there were a lot of midsize and smaller programs that had plastics do their flaps but this seems to be a less and less common arrangement.

 

[Fah-Q]

I have read a lot that ENT do their own free flaps for H+N cases, however was wondering if they are actually trained in micro-vascular anastomosis as well or do they have to call in a plastics guy for that?

Sorry if its been repeated but i did a search and couldn't find a thread on it

If you are free flap trained then you do the whole thing start to finish. The micro is the easy part. Choosing the flap, raising it, insetting it, choosing the neck vessels, arranging the geometry, etc. are much harder. Once you get to the anastomosis it's all really just a technical maneuver that is not that hard. The thousands of little decisions that you make during a flap case that get you to the anastomosis actually present a much greater challenge.