title: Diabetes as main risk factor in head and neck reconstructive surgery with free flaps.
abstract: The aim of our study was to demonstrate the role of certain risk factors in reconstructive head and neck surgery with free flaps. The data taken from the charts of all patients who received free flap for head and neck reconstruction in our department between January 2001 and December 2004 were analyzed. We evaluated the association of preexisting risk factors with the onset of surgical complications such as orocutaneous fistulae, flap infections, hematomas, thrombosis, and necrosis. One hundred and twenty-two free flaps have been used for the reconstruction of head and neck area in 118 patients. Preoperative risk factors included smoking habit (77 patients), alcohol use (6 patients), hypertension (9 patients), diabetes mellitus (8 patients), family history positive for vascular disorders (27 patients), and hypercholesterolemia/hypertriglyceridemia (5 patients). The percentage of full flap survival was 95.08%. Statistical analysis showed that diabetes mellitus (P < 0.01) is significantly associated with a negative prognosis for free flap reconstructive operation, whereas a smoking habit seemed to be at the verge of statistical significance. Therefore, our current practice is to prefer as much as possible the use of local flaps as opposed to free flaps in the reconstruction of head and neck defects in diabetic patients.
authors.affiliation: Maxillo-Facial Surgery Department, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy.
authors.forename: Valentino
authors.initials: V
authors.lastname: Valentini
authors.forename: Andrea
authors.initials: A
authors.lastname: Cassoni
authors.forename: Tito Matteo
authors.initials: TM
authors.lastname: Marianetti
authors.forename: Valeria
authors.initials: V
authors.lastname: Mitro
authors.forename: Paolo
authors.initials: P
authors.lastname: Gennaro
authors.forename: Cristiano
authors.initials: C
authors.lastname: Ialongo
authors.forename: Giorgio
authors.initials: G
authors.lastname: Iannetti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D048909:Diabetes Complications / Q000150:complications* / Q000473:pathology; D003920:Diabetes Mellitus / Q000473:pathology; D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000473:pathology*; D017211:Treatment Failure