File
Authors
Suyama, Yoshiko Department of Plastic and Reconstructive Surgery, Tottori University Hospital Researchers DB KAKEN
Yagi, Shunjiro Department of Plastic and Reconstructive Surgery, Tottori University Hospital Researchers DB KAKEN
Fukuoka, Kohei Department of Plastic and Reconstructive Surgery, Tottori University Hospital
Morita, Maki Department of Plastic and Reconstructive Surgery, Tottori University Hospital
Kinjo, Aya Department of Social Medicine, School of Medicine, Faculty of Medicine, Tottori University Researchers DB KAKEN
Fukuhara, Takahiro Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University Researchers DB KAKEN
Fujiwara, Kazunori Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University Researchers DB KAKEN
Kodani, Isamu Division of Oral and Maxillofacial Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University Researchers DB KAKEN
Osaki, Yoneatsu Department of Social Medicine, School of Medicine, Faculty of Medicine, Tottori University Researchers DB KAKEN
Keywords
flap complication
free flaps
head and neck cancer
microsurgery
risk factors
Abstract
Background: Although head and neck reconstruction using free flaps has become a common procedure, flap complications remain a concern. This study aimed to analyze the risk factors of free flap complications and to identify the causes of these complications. Methods: We studied 97 patients with head and neck cancer with intraoral defects who underwent reconstruction using free flaps at Tottori University Hospital between 2011 and 2020. We used a retrospective cohort study design to investigate whether flap complications, including flap necrosis (total and partial) and flap dehiscence, were related to various factors, including the underlying disease condition, treatment status, and surgical factors. Results: Of the 97 patients analyzed, total flap necrosis was observed in one patient (1.0%). The incidence rate of flap complications, including flap necrosis and flap dehiscence, was 29.9%. When the time taken to perform one vascular anastomosis, including preparation of the recipient vessel and flap vessel, exceeded 30 min, the incidence rates of flap necrosis (total and partial) (odds ratio, 8.30; 95% confidence interval, 1.91-36.00; P = 0.005) and flap dehiscence (odds ratio, 3.46; 95% confidence interval, 1.05-11.36; P = 0.041) increased significantly. Conclusion: The time taken to perform one vessel anastomosis was the factor that contributed the most to the incidence of flap complications. Reconstructive surgeons should reduce the incidence of flap complications by keeping the known risk factors of the surgery in mind and by aiming to complete a vascular anastomosis time, including the time taken for the preparation of vessels, of ≤ 30 min per vessel during surgery.
Publisher
Tottori University Medical Press
Content Type
Journal Article
Link
ISSN
05135710
EISSN
13468049
NCID
AA00892882
Journal Title
Yonago Acta Medica
Current Journal Title
Yonago Acta Medica
Volume
65
Issue
3
Start Page
215
End Page
225
Published Date
2022-08-29
Publisher-DOI
Text Version
Publisher
Rights
(C) 2022 Tottori University Medical Press.
Citation
Yonago Acta Medica. 2022, 65(3), 215-225. doi10.33160/yam.2022.08.007
Department
Faculty of Medicine/Graduate School of Medical Sciences/University Hospital
Language
English