Prognostic Factors for Free Flap Failure in Head and Neck Reconstruction.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-02-06 DOI:10.1002/hed.28095

Quentin Hennocq, Jean-Baptiste Caruhel, Mourad Benassarou, Jebrane Bouaoud, André Chaine, Angélique Girod, Nicolas Graillon, Sylvie Testelin, Mélika Amor-Sahli, Jean-Philippe Foy, Chloé Bertolus

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引用次数: 0

Abstract

Background: The failure rate of free flaps varies from 0.8% to 10.6% in the literature in head and neck reconstruction. The primary objective was to identify prognostic factors for free flap failure.

Methods: We prospectively included all consecutive free flaps performed between August 2021 and January 2024, and used a multivariate Cox proportional hazard model.

Results: We included 307 free flaps, performed on 274 patients. Age, cardiovascular risk, radiotherapy history, type of flap, type of arterial anastomosis, and ischemia duration were not statistically linked to the risk of flap failure. In multivariate analysis, a venous anastomosis to the anterior jugular vein or to the superior thyroid vein were associated with an increased risk of flap failure, such as per- or postoperative revision of the anastomoses.

Conclusions: The choice of venous anastomosis, appear to have a greater influence on the success or failure of a microvascularized transfer than patient characteristics.

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头颈部重建游离皮瓣失败的预后因素分析。

背景：在头颈部重建的文献中，自由皮瓣的失败率从0.8%到10.6%不等。主要目的是确定游离皮瓣失败的预后因素。方法：我们前瞻性地纳入了2021年8月至2024年1月期间进行的所有连续自由皮瓣，并使用多变量Cox比例风险模型。结果：我们纳入307个游离皮瓣，对274例患者进行了手术。年龄、心血管风险、放疗史、皮瓣类型、动脉吻合类型、缺血时间与皮瓣衰竭风险无统计学相关性。在多因素分析中，颈前静脉或甲状腺上静脉的静脉吻合与皮瓣失败的风险增加有关，如吻合口的术前或术后翻修。结论：静脉吻合术的选择对微血管移植的成功或失败的影响大于患者的特征。

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

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.