Clinical effectiveness of postoperative prostaglandin E1 administration in reducing flap necrosis following microsurgical reconstruction

IF 1.5 3区医学 Q3 SURGERY

Microsurgery Pub Date : 2024-03-28 DOI:10.1002/micr.31166

Se Yeon Park MD, Kyeong-Tae Lee MD, PhD

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引用次数: 0

Abstract

Background

Extensive experimental evidence has suggested the potential efficacy of prostaglandin E1 (PGE1) in enhancing flap survival, leading to its widespread empirical use following free flap operation. However, the translation of these experimental findings into clinical benefits remains uncertain. This study aimed to assess the clinical effectiveness of postoperative PGE1 administration on the outcomes of microsurgical reconstruction.

Methods

A retrospective review was conducted for patients who underwent free flap-based reconstruction between September 2020 and November 2022, dividing into two cohorts. For all consecutive cases conducted during the formal half, PGE1 was administered for postoperative 7 days (PGE1 cohort), and for those during the latter, PGE1 was not given (non-PGE1 cohort). The profiles of perfusion-related complications (PRC) were compared between the two cohorts. Further analyses after propensity-score matching were performed.

Results

In total, 274 cases were analyzed, consisting of 142 in PGE1 and 132 in non-PGE1 cohort. Baseline characteristics were similar between the two cohorts, except for higher rates of comorbidities and chronic wound-related defects in the PGE1 cohort. Overall PRC developed in 37 cases (13.5%), including 6 (2.1%) total loss and 38 (10.2%) partial necrosis. Compared to the control, the PGE1 cohort exhibited significantly lower rates of overall PRC and partial flap necrosis. This difference remained significant on multivariable analyses. The rate of total flap loss did not differ between the cohorts. Consistent associations were observed in the propensity-score matching analysis.

Conclusion

Postoperative administration of PGE1 appears to be associated with reduced risks for the development of partial flap necrosis.

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术后服用前列腺素 E1 对减少显微外科重建术后皮瓣坏死的临床效果。

背景：大量实验证据表明，前列腺素 E1（PGE1）具有提高皮瓣存活率的潜在功效，因此在游离皮瓣手术后被广泛应用。然而，这些实验结果能否转化为临床疗效仍不确定。本研究旨在评估术后使用 PGE1 对显微外科重建的临床效果：方法：对 2020 年 9 月至 2022 年 11 月期间接受游离皮瓣重建术的患者进行回顾性研究，分为两个队列。在前半期进行的所有连续病例中，术后 7 天均使用 PGE1（PGE1 组），而在后半期进行的病例中，则不使用 PGE1（非 PGE1 组）。两组患者的灌注相关并发症（PRC）情况进行了比较。结果：共分析了 274 个病例：共分析了 274 例病例，其中 PGE1 组 142 例，非 PGE1 组 132 例。两个队列的基线特征相似，只是 PGE1 队列中合并症和慢性伤口相关缺陷的比例较高。共有 37 例（13.5%）发生了 PRC，其中 6 例（2.1%）完全坏死，38 例（10.2%）部分坏死。与对照组相比，PGE1 组的总体 PRC 和皮瓣部分坏死率明显较低。在多变量分析中，这一差异仍然明显。两组患者的皮瓣全损率没有差异。在倾向分数匹配分析中观察到了一致的关联：结论：术后使用 PGE1 似乎与部分皮瓣坏死的发生风险降低有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microsurgery 医学-外科

CiteScore

3.80

自引率

19.00%

发文量

128

审稿时长

4-8 weeks

期刊介绍： Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.