Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
3131881 | International Journal of Oral and Maxillofacial Surgery | 2016 | 5 Pages |
Abstract
The medical records of patients who had undergone a free flap reconstruction after radical resection of oral cancer between January 2009 and December 2013 at the study hospital in China were reviewed retrospectively. Of the 1550 patients who underwent free flap reconstructions, 71 were explored for suspected flap compromise caused by postoperative thrombosis. Patient demographic data, clinicopathological data of the tumour, details of the free flaps, and operative findings were assessed, and the medical records were analyzed to identify the reasons for intervention and the outcomes. Of the 71 flaps in crisis, 47 (66.2%) were salvaged. Free flap failure was 6.2-times more likely to develop in patients undergoing surgical exploration after 72Â h (95% confidence interval 2.090-18.197, PÂ =Â 0.001). Of the 19 flaps identified as subject to delayed exploration, 14 failed and three had partial necrosis. Free flap failure was 3.4-times more likely to develop in patients with perforator flaps (95% confidence interval 1.222-9.719, PÂ =Â 0.019). The early detection of free flap failure is critical to flap salvage. The salvage success rate decreases significantly at >72Â h after the initial operation. It appears to be more difficult to salvage a perforator flap.
Keywords
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Dentistry, Oral Surgery and Medicine
Authors
X. Yang, S. Li, K. Wu, L. Hu, W. Liu, T. Ji, Y. Hu, L. Xu, J. Sun, Z. Zhang, C. Zhang,