title: Effects of radiation therapy on postoperative complications and adverse events in patients with head and neck reconstruction with flaps.
abstract: BACKGROUND
  Radiation therapy is an essential treatment for head and neck cancer. However, the condition of the operative field is entirely altered after radiation therapy. This study aimed to examine the effects of preoperative radiation therapy on complications in patients who underwent head and neck reconstruction with flaps.
  
  
  METHODS
  We retrospectively reviewed 252 instances of head and neck reconstruction with flaps in 240 patients between October 2000 and May 2011 at Okayama University Hospital. Of the participants, 51 had preoperative radiation exposure (21.3%) and 189 had no radiation exposure (78.7%). Postoperative complications were divided into three categories: minor complications that healed with conservative medical treatment within 4 weeks without a need for surgery; major complications requiring reoperation within 1 week after surgery (reoperation); and major complications needing additional operation later than 1 week after surgery (additional operation).
  
  
  RESULTS
  Preoperative radiation therapy was only associated with major complications requiring reoperation later than 1 week after surgery (P < 0.001), open cervical wounds (P = 0.0030), and skin grafting for cervical skin necrosis (P = 0.0031) when compared to no radiation exposure. The results of flap failure were not significantly different between both groups (P = 0.3820).
  
  
  CONCLUSIONS
  Minor complications and reoperation in the early postoperative period were not influenced by radiation exposure. The complications of radiation tend to be protracted and associated with additional operation later than 1 week after the initial surgery. It was thought that shortening of the duration of treatment was successful when we needed to perform early additional operations.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, University of Okayama, Okayama, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Onoda
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kimata
authors.forename: Narushi
authors.initials: N
authors.lastname: Sugiyama
authors.forename: Tomoo
authors.initials: T
authors.lastname: Onoda
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Mizukawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011183:Postoperative Complications; D011878:Radiotherapy / Q000009:adverse effects; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012886:Skull / Q000601:surgery; D013524:Surgical Flaps