title: Risk factors of free flap compromise in 247 cases of microvascular head and neck reconstruction: a single surgeon's experience.
abstract: 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.
authors.affiliation: 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.
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Joo
authors.forename: Dong-Il
authors.initials: DI
authors.lastname: Sun
authors.forename: Jun-Ook
authors.initials: JO
authors.lastname: Park
authors.forename: Kwang-Jae
authors.initials: KJ
authors.lastname: Cho
authors.forename: Min-Sik
authors.initials: MS
authors.lastname: Kim
mesh_terms: 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
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