Preoperative Predictors of Free Flap Failure.
Otolaryngol Head Neck Surg
; 168(2): 180-187, 2023 02.
Article
in En
| MEDLINE
| ID: mdl-35412879
ABSTRACT
OBJECTIVE:
Microvascular free tissue transfer is an important reconstructive option for defects of the head and neck. The present study aims to identify preoperative patient- and tumor-specific characteristics, laboratory values, and other risk factors associated with early free flap failure. STUDYDESIGN:
Retrospective cohort study of 1070 patients.SETTING:
Head and neck surgical oncology service at a tertiary care center from 2005 to 2019.METHODS:
Demographics, comorbidities, preoperative laboratory values, treatment history, and cancer stage were collected for consecutive patients who underwent free flap reconstruction of the head and neck and experienced early free flap failure (<8 days from surgery).RESULTS:
In 1070 patients, the prevalence of early free flap failure was 3.8% (n = 41). Female sex (odds ratio [OR], 2.58; 95% CI, 1.36-4.99), presence of peripheral vascular disease (OR, 2.78; 95% CI, 1.05-6.57), and elevated preoperative platelet count (OR, 2.67; 95% CI, 1.20-5.47) were independently associated with risk of early free flap failure.CONCLUSION:
Female sex, peripheral vascular disease, and preoperative thrombocytosis are all strong predictors of early free flap failure. This suggests that hypercoagulability and poor vessel quality may predispose patients to flap loss. Patients with elevated platelets or peripheral vascular disease warrant careful reconstructive decision making and close monitoring in the perioperative period.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Plastic Surgery Procedures
/
Free Tissue Flaps
/
Head and Neck Neoplasms
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
Language:
En
Journal:
Otolaryngol Head Neck Surg
Journal subject:
OTORRINOLARINGOLOGIA
Year:
2023
Document type:
Article
Affiliation country:
Estados Unidos