title: Perioperative serum levels of procalcitonin, C-reactive protein, and leukocytes in head and neck free flaps.
abstract: Microvascular free flaps are considered to be the gold standard in reconstructive head and neck surgery. However, reduced postoperative transplant perfusion is one of the serious postoperative complications and calls for close and reliable monitoring. Procalcitonin, C-reactive protein, and leukocytes are closely associated with local and systemic inflammatory reactions and might have prognostic capacity concerning tissue necrosis. This study aimed to evaluate perioperative serum levels of these three biomarkers to assess their potential in postoperative flap monitoring. A total of 100 patients with microvascular head and neck reconstructions were included in the study. Perioperative serum levels of parameters were measured and the clinical data were analyzed and correlated. A total of 13% of all flaps developed reduced postoperative perfusion. Analysis of the parameters revealed statistically significant differences in the overall patient collective over time, irrespective of clinically reduced flap perfusion. Co-factors such as sex and history of tobacco and alcohol abuse showed significant differences. The efficacy of the parameters in free flap monitoring has not been verified, although the role of procalcitonin in postoperative monitoring, with special regard to the early detection of infections, is underlined by the present study results.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Munich (TUM), Munich, Germany. Electronic address: steffen.koerdt@tum.de.
authors.forename: S
authors.initials: S
authors.lastname: Koerdt
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Munich (TUM), Munich, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Rommel
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Munich (TUM), Munich, Germany.
authors.forename: N H
authors.initials: NH
authors.lastname: Rohleder
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Munich (TUM), Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Sandig
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Munich (TUM), Munich, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Frohwitter
authors.affiliation: Department of Oral and Maxillofacial Surgery, RWTH Aachen, Aachen, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Steiner
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Munich (TUM), Munich, Germany.
authors.forename: K D
authors.initials: KD
authors.lastname: Wolff
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University of Munich (TUM), Munich, Germany.
authors.forename: M R
authors.initials: MR
authors.lastname: Kesting
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000097:blood*; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods*
chemical_list: D015415:Biomarkers; D002116:Calcitonin; D002097:C-Reactive Protein
keywords: CRP; PCT; free flap; leukocytes; microsurgery; reconstructive surgery