Risk factors of free flap compromise in 247 cases of microvascular head and neck reconstruction: a single surgeon's experience.
The aim of this study was to evaluate relationships between free flap compromise and perioperative risk factors. A retrospective review was conducted for 237 patients who underwent 247 microvascular free flap reconstructions after head and neck ablative surgery. Twenty-one (8.5%) cases of free flap compromise due to a vascular obstruction were identified, and 11 flaps were lost (4.5%); an overall success rate of 95.5%. A significant correlation was found between diabetes mellitus and free flap compromise (p = 0.048). Preoperative irradiation was also found to influence free flap compromise, but with borderline significance (p = 0.052). However, multivariate analysis revealed a significant association between free flap compromise and diabetes mellitus [odds ratio = 4.9 (95% CI 1.1-22.8, p = 0.041)]. The presence of diabetes mellitus may require more attention to improve patient management and free flap outcomes.
Joo
Young-Hoon
YH
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 505 Banpodong, Seochogu, Seoul, 137-040, Korea.
Sun
Dong-Il
DI
Park
Jun-Ook
JO
Cho
Kwang-Jae
KJ
Kim
Min-Sik
MS
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D058752:Free Tissue Flaps; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
J Plast Reconstr Aesthet Surg. 2009 Jul;62(7):889-95
18440289
Strahlenther Onkol. 2002 Jun;178(6):299-306
12122785
J Craniomaxillofac Surg. 2003 Aug;31(4):197-201
12914703
Plast Reconstr Surg. 2007 Jun;119(7):2092-2100
17519706
Plast Reconstr Surg. 1997 Jan;99(1):156-62
8982199
J Trauma. 1989 Aug;29(8):1086-94
2668545
J Plast Reconstr Aesthet Surg. 2006;59(7):737-42
16782570
Radiother Oncol. 2009 Sep;92(3):477-83
19541382
Clin Plast Surg. 1992 Oct;19(4):773-81
1339635
Clin Plast Surg. 1993 Jul;20(3):435-53
8324983
Br J Plast Surg. 1989 Jan;42(1):50-3
2917217
Am J Surg. 1993 Oct;166(4):326-30
8214285
Diabetes Metab Res Rev. 2004 May-Jun;20 Suppl 1:S78-89
15150819
J Craniofac Surg. 2008 Jul;19(4):1080-4
18650736
Plast Reconstr Surg. 1986 Sep;78(3):285-92
3737751
Plast Reconstr Surg. 1998 Sep;102(3):711-21
9727436