Cuidados perioperatorios en pacientes con colgajos libres: experiencia institucional.

Background and objective. The outcomes and survival of microvascular flaps depend not only on surgical technique but also on various perioperative variables. Therefore, it is crucial to provide ideal conditions for the patient to ensure the survival of free flaps. We present our experience with standardized perioperative variables and additionally we conduct a brief retrospective comparison of the population undergoing free flap reconstruction before the implementation of control measures for these variables and the population in which this control was standardized. Methods. Patients undergoing microsurgical reconstruction with free flaps from 2020 to 2023 were managed under a set of predetermined standardized measures. The analysis includes 14 perioperative measures, considering flap loss as the dependent variable. Additionally, minor complications such as infections, dehiscences, hematomas and partial necrosis, among others, were documented. Each result was analyzed and compared with current scientific evidence to determine its utility. Results. A total of 86 patients were evaluated with cancer being the most common indication for surgery, followed by trauma. The flap loss rate was 5.8%, with thrombosis being the most frequent complication (80%). Minor complications included dehiscences, hematomas, and partial flap necrosis. The overall infection rate was 1.2%. Conclusions. Our study highlights the importance of various pre, intra and postoperative variables that directly or indirectly influence flap survival. Furthermore, it demonstrates that, in our case series, the standardized institutional perioperative management measures used have a positive outcome in the majority of patients, promoting the survival of free flaps and reducing the rate of minor complications. [ABSTRACT FROM AUTHOR]