scholarly journals Six-year experience of microvascular free-flap reconstruction of head and neck neoplasms

2021 ◽  
Vol 78 (4) ◽  
pp. 335-339
Author(s):  
Santiago Olguín Joseau ◽  
Ariel Arias ◽  
Juan Carlos Sánchez ◽  
Pablo Valle ◽  
Agustín Garzón Bertola ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Head And Neck ◽  
Free Flap ◽  
Head And Neck Neoplasms ◽  
Site Infection ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Surgical Time ◽  
Microvascular Free Flap

Introduction: Microvascular free-flap reconstruction is one of the treatment options after large resection of head and neck neoplasms. The objectives of this study are to identify short-term outcomes and risk factors for flap complication in patients who underwent neoplasms resection of head and neck with microvascular free-flap reconstruction. Methods: Retrospective study of patients who underwent surgery for head and neck neoplasm with microvascular free-flap reconstruction between January 2014-2020. Complications were studied at 30-days follow-up and divided into medical and flap complications. Factors independently associated with flap complication were analyzed. Results: We included 31 patients (15 men). The mean age was 60 years. Reconstruction was performed with radial-forearm flap in 74% (n=23) and with free-fibula flap in 26% (n=8). Mean surgical time was 420 minutes. Median hospital length of stay was 7 days. Medical complications were of 23%. Minor complications were of 35% and major of 32%. There was no mortality in 30-days follow-up. Flap complications were of 35%. Reintervention was of 29%, surgical site infection of 9%, dehiscence of 29% and flap loss of 9.7%.  Surgical site infection was independently associated with prolonged surgical time (Odds ratio [OR]=1.03, IC95%=0.98-1.04, p=0.02) and body mass index equal to or greater than 30 (OR=1.38, IC95%=0.84-2.26, p=0.04) while flap loss was associated with prolonged surgical time (OR=1.02, IC95%=0.99-1.04, p=0.01). Conclusion: Microsurgical free-flap reconstruction should be considered in our population in patients with large head and neck neoplasms. Preoperative assessment of the risk of postoperative complications is essential before selecting patients for this surgery.

scholarly journals Postoperative care in an intermediate-level medical unit after head and neck microvascular free flap reconstruction

2018 ◽  
Vol 4 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Phoebe K. Yu ◽  
Rosh K.V. Sethi ◽  
Vinay Rathi ◽  
Sidharth V. Puram ◽  
Derrick T. Lin ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Postoperative Care ◽  
Intermediate Level ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Medical Unit ◽  
Microvascular Free Flap

Head and neck microvascular free flap reconstruction: An analysis of unplanned readmissions

2016 ◽  
Vol 127 (2) ◽  
pp. 325-330 ◽  
Author(s):  
Eric T. Carniol ◽  
Emily Marchiano ◽  
Jacob S. Brady ◽  
Aziz M. Merchant ◽  
Jean Anderson Eloy ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Microvascular Free Flap

scholarly journals Reconstructive trends and complications following parotidectomy: incidence and predictors in 11,057 cases

2019 ◽  
Vol 48 (1) ◽  
Author(s):  
Cory Donovan Bovenzi ◽  
Peter Ciolek ◽  
Meghan Crippen ◽  
Joseph M. Curry ◽  
Howard Krein ◽  
...  
Keyword(s):  
Adverse Events ◽  
Facial Nerve ◽  
Surgical Site Infection ◽  
Free Flap ◽  
Malignant Tumor ◽  
Site Infection ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Reconstructive Procedures ◽  
Nerve Paralysis

Abstract Background Parotidectomy is a common treatment option for parotid neoplasms and the complications associated with this procedure can cause significant morbidity. Reconstruction following parotidectomy is utilized to address contour deformity and facial nerve paralysis. This study aims to demonstrate national trends in parotidectomy patients and identify factors associated with adverse postoperative outcomes. This study includes the largest patient database to date in determining epidemiologic trends, reconstructive trends, and prevalence of adverse events following parotidectomy. Methods A retrospective review was performed for parotidectomies included in the ACS-NSQIP database between January 2012 and December 2017. CPT codes were used to identify the primary and secondary procedures performed. Univariate and multivariate analysis was utilized to determine associations between pre- and perioperative variables with patient outcomes. Preoperative demographics, surgical indications, and common medical comorbidities were collected. CPT codes were used to identify patients who underwent parotidectomy with or without reconstruction. These pre- and perioperative characteristics were compared with 30-day surgical complications, medical complications, reoperation, and readmission using uni- and multivariate analyses to determine predictors of adverse events. Results There were 11,057 patients who underwent parotidectomy. Postoperative complications within 30 days were uncommon (1.7% medical, 3.8% surgical), with the majority of these being surgical site infection (2.7%). Free flap reconstruction, COPD, bleeding disorders, smoking, and presence of malignant tumor were the strongest independent predictors of surgical site infection. Readmission and reoperation were uncommon at an incidence of 2.1% each. The strongest factors predictive of readmission were malignant tumor and corticosteroid usage. The strongest factors predictive of reoperation were free flap reconstruction, malignant tumor, bleeding disorder, and disseminated cancer. Surgical volume/contour reconstruction was relatively uncommon (18%). Facial nerve sacrifice was uncommon (3.7%) and, of these cases, only 25.5% underwent facial nerve reinnervation and 24.0% underwent facial reanimation. Conclusions There are overall low rates of complications, readmissions, and reoperations following parotidectomy. However, certain factors are predictive of adverse postoperative events and this data may serve to guide management and counseling of patients undergoing parotidectomy. Concurrent reconstructive procedures are not commonly reported which may be due to underutilization or underreporting.

Impact of skeletal muscle mass volume on surgical site infection in free flap reconstruction for oral cancer

Microsurgery ◽  
2019 ◽  
Vol 39 (7) ◽  
pp. 598-604 ◽  
Author(s):  
Takaya Makiguchi ◽  
Takahiro Yamaguchi ◽  
Hideharu Nakamura ◽  
Keisuke Suzuki ◽  
Norifumi Harimoto ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Oral Cancer ◽  
Surgical Site Infection ◽  
Muscle Mass ◽  
Free Flap ◽  
Skeletal Muscle Mass ◽  
Site Infection ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Mass Volume
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