title: Factors in Free Fasciocutaneous Flap Complications: A Logistic Regression Analysis.
abstract: BACKGROUND
  Free tissue transfer using fasciocutaneous flaps has increased in frequency over the past decade. Predictive analyses are lacking for fasciocutaneous free flaps in terms of complication rates for reconstruction. This study therefore was designed to identify key variables that drive complications in fasciocutaneous free flap surgery.
  
  
  METHODS
  A retroactive chart review of 91 patients undergoing 91 fasciocutaneous flaps was performed. Twelve variables were identified and tracked through clinic and hospital charts (i.e., surgeon experience, hospital, age, flap type, traumatic wound, smoking, large fasciocutaneous flap, type of anastomosis, recipient vessel choice, sex, anatomical region of wound, and flap debulking). A logistic regression model was used to determine the presence of complications associated with the prescribed predictors.
  
  
  RESULTS
  The model revealed that smoking, age, anatomical area of wound, flap size, flap type, and presence of a traumatic wound impacted complications. The model was found to be a good fit (Hosmer-Lemeshow, p = 0.135). Factors impacting complications with fasciocutaneous flaps included anatomical area (62.3 percent increase in complications; p = 0.047), surgeon experience (27 percent reduction in complications; p = 0.007), and reconstruction of a trauma activation patient (80 percent reduction in complications; p = 0.025).
  
  
  CONCLUSIONS
  The implications of these findings can be used to contain cost and minimize poor outcomes within the health care system.
authors.affiliation: Phoenix, Ariz. From the Arizona Center for Hand Surgery.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Reece
authors.forename: Michael A
authors.initials: MA
authors.lastname: Bonelli
authors.forename: Tyler
authors.initials: T
authors.lastname: Livingston
authors.forename: Paul S
authors.initials: PS
authors.lastname: Mulligan
authors.forename: Johnathan
authors.initials: J
authors.lastname: Rockwood
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Wilson
authors.forename: Jozef
authors.initials: J
authors.lastname: Zoldos
authors.forename: Lloyd
authors.initials: L
authors.lastname: Champagne
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000209:etiology*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors