title: Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as predictors of wound healing failure in head and neck reconstruction.
abstract: CONCLUSIONS
  In microsurgical head and neck reconstruction, a higher rate of post-operative wound complication could be predicted by a lower pre-operative neutrophil ratio (< 64.9%), neutrophil-lymphocyte ratio (NLR) (< 3.5), and platelet-lymphocyte ratio (PLR) (< 160).
  
  
  OBJECTIVE
  To evaluate the predictor of post-operative wound complications in microsurgical head and neck reconstruction.
  
  
  METHODS
  Patients who were undergoing tumor ablation and microsurgical reconstruction from April 2011 to March 2014 were analyzed retrospectively. The pre-operative hematological data, age, sex, co-morbidities, body mass index (BMI), adjuvant therapies, smoking, operation time, blood loss, total protein, T-stage, and Anesthesiologists Performance Status (ASA-PS) score were collected. Cases of post-operative wound healing failure were reviewed.
  
  
  RESULTS
  One hundred and three consecutive patients were enrolled. Among these, the results of 77 patients who were younger than 70 years of age were analyzed. The distributions of the neutrophil ratio (p = .0005), lymphocyte ratio (p = .0166), monocyte ratio (p = .0341), NLR (p = .005), and PLR (p = .008) differed significantly between the patients with and without post-operative wound healing failure. Neutrophil ratio, NLR, and PLR cut-off values of 64.9, 3.5, and 160 were significantly associated with the rate of wound healing failure rate (p = .0002, .00021, .0042, respectively).
authors.affiliation: a Division of Plastic and Reconstructive Surgery , Shizuoka Cancer Center , Shizuoka , Japan.|b Department of Plastic and Reconstructive Surgery, Graduate School of Science , Tokyo Medical and Dental University , Tokyo , Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Maruyama
authors.affiliation: a Division of Plastic and Reconstructive Surgery , Shizuoka Cancer Center , Shizuoka , Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Inoue
authors.affiliation: c Department of Clinical Trial Coordination Office , Shizuoka Cancer Center , Shizuoka , Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Mori
authors.affiliation: a Division of Plastic and Reconstructive Surgery , Shizuoka Cancer Center , Shizuoka , Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Gorai
authors.affiliation: a Division of Plastic and Reconstructive Surgery , Shizuoka Cancer Center , Shizuoka , Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Shimamoto
authors.affiliation: d Department of Head and Neck Surgery , Shizuoka Cancer Center , Shizuoka , Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Onitsuka
authors.affiliation: e Department of Otolaryngology, Head and Neck Surgery , Osaka City University Graduate School of Medicine , Osaka , Japan.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Iguchi
authors.affiliation: b Department of Plastic and Reconstructive Surgery, Graduate School of Science , Tokyo Medical and Dental University , Tokyo , Japan.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Okazaki
authors.affiliation: a Division of Plastic and Reconstructive Surgery , Shizuoka Cancer Center , Shizuoka , Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakagawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D058752:Free Tissue Flaps; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology*; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D014945:Wound Healing / Q000276:immunology*; D055815:Young Adult
keywords: Surgical site infection; fistula; microsurgery; risk factor; wound healing