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Fibula Free Flap in Head and Neck Reconstruction: Identifying Risk Factors for Flap Failure and Analysis of Postoperative Complications in a Low Volume Setting
- Source :
- Craniomaxillofac Trauma Reconstr
- Publication Year :
- 2019
- Publisher :
- SAGE Publications, 2019.
-
Abstract
- The fibula free flap (FFF) has been a workhorse in maxillofacial reconstruction. High success rates of this technique are reported. However, identifying risk factors for flap failure and analyzing complications can open the way to better patient care. A retrospective analysis was conducted of all FFFs performed over a 20-year period at a low-volume single tertiary center to identify risk factors and postoperative complications. A total of 129 FFFs were included (122 mandible, 7 maxilla). Complete flap failure occurred in 12.4% and partial flap failure in 7.8% of patients. A significant relation was found between younger age and flap failure, and most failures were associated with venous thrombosis. In-hospital surgical complications occurred in 60.5%, in-hospital medical complications in 49.6%, and out-of-hospital complications in 77.5% of patients. The in-hospital reintervention rate was 27.1%, and including salvaged flaps, flap survival rate was 87.6%. Osteomyocutaneous FFF failure (complete 12.4%; partial 7.8%) is an important clinical reality in a low-volume head and neck reconstruction center resulting in an in-hospital reintervention rate of 27.1%. Postoperative complications are frequent, both surgical and out-hospital complications. These results provide a better understanding of the limitations of the FFF in a low-volume center and can be used to optimize care in this kind of setting.
- Subjects :
- medicine.medical_specialty
business.industry
Flap failure
Free flap
030230 surgery
medicine.disease
Surgery
03 medical and health sciences
Venous thrombosis
0302 clinical medicine
Otorhinolaryngology
030220 oncology & carcinogenesis
Maxilla
Medicine
Oral Surgery
Risk factor
Fibula
business
Complication
Head and neck
Subjects
Details
- ISSN :
- 19433883 and 19433875
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- Craniomaxillofacial Trauma & Reconstruction
- Accession number :
- edsair.doi.dedup.....9a62d713745083e749d252fcfac5df9c