Microsurgical reconstruction in patients greater than 80 years old.

Heidekrueger, Paul I; Heine-Geldern, Albrecht; Ninkovic, Milomir; Herter, Frank; Schmauss, Daniel; Aung, Thiha; Broer, P Niclas

doi:10.1002/micr.30132

2017

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Titel:: Microsurgical reconstruction in patients greater than 80 years old.
Dokumenttyp:: Journal Article
Autor(en):: Heidekrueger, Paul I; Heine-Geldern, Albrecht; Ninkovic, Milomir; Herter, Frank; Schmauss, Daniel; Aung, Thiha; Broer, P Niclas
Abstract:: Demographic change implies that the human population is getting older and the elderly are living longer. Consequently, achieving good functional and aesthetic outcomes in microvascular procedures, especially in very old patients with higher incidence of atherosclerosis and vessel calcifications, constitutes a microsurgical challenge. This study evaluates the feasibility of microsurgical procedures in a very old patient cohort.Between 2009 and 2015, 754 patients underwent 838 free flap reconstructions. The patients were divided into two groups according to age in "middle-aged" (<80 years old; n = 711) or "very old" (>=80 years old; n = 43). The series was retrospectively analyzed regarding potential influence of medical comorbidities, surgical and medical complications and outcomes.Between the groups, there was a significant difference regarding comorbidities with a higher prevalence of hypertension (P < 0.0001) and peripheral artery disease (P < 0.0001) in the very old group. However, there was no significant difference regarding the rate of surgical or medical complications, flap failure (middle aged group 43/791 flaps (5.44%) versus very old group 4/47 flaps (8.51%); P = 0.328), and revision rate (117/791 flaps (14.79%) versus 6/47 flaps (12.77%); P = 0.834) between the patient groups during our 3-months follow-up period.Our findings suggest that despite higher rates of patient comorbidities, successful free tissue transfer can also be achieved in a very old population with acceptable risk for complications.
Zeitschriftentitel:: Microsurgery
Jahr:: 2017
Band / Volume:: 37
Heft / Issue:: 6
Seitenangaben Beitrag:: 546-551
Sprache:: eng
Volltext / DOI:: doi:10.1002/micr.30132
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/27898199
Print-ISSN:: 0738-1085
TUM Einrichtung:: Lehrstuhl für Plastische Chirurgie und Handchirurgie (Prof. Machens)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie (Prof. Machens)Lehrstuhl für Plastische Chirurgie und Handchirurgie (Prof. Machens)2017