Hardware complications in oromandibular defects: Comparing scapular and fibular based free flap reconstructions.

<bold>Background: </bold>Despite improvements in surgical technique and technology, hardware complications occur relatively frequently. This study analyzes hardware complications in patients undergoing oromandibular reconstruction using scapular (SFF) or fibular (FFF) free flaps.<bold>Methods: </bold>Retrospective data for 178 patients was obtained (1999-2014) at University Hospital Network (Toronto, Canada). Univariable and multivariable analyses were performed to identify risk factors for hardware complications.<bold>Results: </bold>Patients with FFF reconstruction (n=129) had significantly more hardware complications than those with SFF (n=49) (16% vs. 2%;p=0.01). Surgical site infection (SSI) (OR=7.05; p<0.01), defect type (OR=2.63; p<0.01) and flap (OR=0.12; p=0.01) were significant predictors of hardware complications on univariable analysis. Flap type (OR=0.12; p=0.04) was an independent predictor of plate complication after adjusting for SSI. A subgroup analysis suggested a trend towards fewer hardware complications with SFF stratified by mandibular defect type.<bold>Conclusions: </bold>Scapular free flaps are associated with a lower rate of hardware-related complications in oromandibular reconstruction. [ABSTRACT FROM AUTHOR]