Predictors of free flap loss in the head and neck region: A four-year retrospective study with 451 microvascular transplants at a single centre.

Mücke, Thomas; Ritschl, Lucas M; Roth, Maximilian; Güll, Florian D; Rau, Andrea; Grill, Sonja; Kesting, Marco R; Wolff, Klaus-Dietrich; Loeffelbein, Denys J

doi:10.1016/j.jcms.2016.04.029

2016

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Titel:: Predictors of free flap loss in the head and neck region: A four-year retrospective study with 451 microvascular transplants at a single centre.
Dokumenttyp:: Journal Article
Autor(en):: Mücke, Thomas; Ritschl, Lucas M; Roth, Maximilian; Güll, Florian D; Rau, Andrea; Grill, Sonja; Kesting, Marco R; Wolff, Klaus-Dietrich; Loeffelbein, Denys J
Abstract:: Microvascular free flaps have become an essential part of reconstructive surgery following head and neck tumour ablation. The authors' aim was to investigate the influence of cardiovascular risk factors, preoperative irradiation, previous operations and metabolically active medication on free flap loss in order to predict patients at risk and to improve their therapy.All patients who underwent reconstructive surgery with microvascular free flaps in the head and neck region between 2009 and 2013 were retrospectively analysed. Uni- and multivariate logistic regressions were performed to determine the association between possible predictor variables for free flap loss.We included 451 patients in our analysis. The overall free flap failure rate was 4.0%. Multivariate regression analysis revealed significantly increased risks of free flap failure depending on prior attempts at microvascular transplants (p < 0.001, OR = 14.21) and length of hospitalisation (p = 0.007, OR = 1.05).With consistently low rates of flap failure, microvascular reconstruction of defects in the head and neck region has proven to be highly reliable, even in patients with comorbidities. The expertise of the operating team seems to remain the main factor affecting flap success. The only discerned independent predictor was previously failed attempts at microvascular reconstruction.
Zeitschriftentitel:: J Craniomaxillofac Surg
Jahr:: 2016
Band / Volume:: 44
Heft / Issue:: 9
Seitenangaben Beitrag:: 1292-8
Sprache:: eng
Volltext / DOI:: doi:10.1016/j.jcms.2016.04.029
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/27527675
Print-ISSN:: 1010-5182
TUM Einrichtung:: Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie (Prof. Wolff)2016