yam65(3)_215.pdf 763 KB
Fukuoka Kohei Department of Plastic and Reconstructive Surgery, Tottori University Hospital
Morita, Maki Department of Plastic and Reconstructive Surgery, Tottori University Hospital
金城 文 Department of Social Medicine, School of Medicine, Faculty of Medicine, Tottori University 研究者総覧 KAKEN
福原 隆宏 Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University 研究者総覧 KAKEN
藤原 和典 Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University 研究者総覧 KAKEN
小谷 勇 Division of Oral and Maxillofacial Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University 研究者総覧 KAKEN
head and neck cancer
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.
Tottori University Medical Press
Yonago Acta Medica
Yonago Acta Medica
(C) 2022 Tottori University Medical Press.
Yonago Acta Medica. 2022, 65(3), 215-225. doi10.33160/yam.2022.08.007