Analysis of risk factors of free flap crisis in 14 of 273 consecutive patients with free flap reconstruction of oral and maxillofacial defects

Abstract

Abstract: PURPOSE: To investigate related risk factors of flap crisis in head and neck reconstruction, summarize experiences, and improve the success rate. METHODS: We retrospectively reviewed 273 free flaps for head and neck defect reconstruction from 2006 to 2015. Among those, 14 cases developed from flap crisis. The related risk factors were analyzed, and the salvage success rate within 6 h from the initial suspicion of flap crisis was assessed. SPSS 21.0 software package was employed to analyze the data. RESULTS: Risk factors such as small airway dysfunction, alcohol withdrawal reaction, overweight (BMI>25) were not related to the incidence of flap crisis (P>0.05). However, local or systemic postoperative infection was significantly related to flap crisis (P<0.01). The salvage rate of surgical exploration was 33.3% over 72 h postoperatively. CONCLUSIONS: Local or systemic infection was a high risk factor for free flap crisis. Greater BMI, small airway dysfunction, and alcohol withdrawal reaction were not related to free flap crisis. The later the free flap crisis occurred, the lower salvage rate. Once suspicious flap crisis occurs, even more than 72 h after operation, surgical exploration also benefits in helping to improve salvage rate.

Key words: Free flaps, Surgical exploration, Flap crisis, Risk factors

CLC Number:

R782.2

WANG Jia, BAI Shuang, SUN Chang-fu, LIU Fa-yu, XU Zhong-fei. Analysis of risk factors of free flap crisis in 14 of 273 consecutive patients with free flap reconstruction of oral and maxillofacial defects[J]. China Journal of Oral and Maxillofacial Surgery, 2016, 14(6): 538-541.

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