Outcomes and perioperative risk factors after oncologic free-flap scalp reconstruction Journal Article
| Authors: | Yu, J. W.; Chu, J. J.; Franck, P.; Polanco, T. O.; Shamsunder, M. G.; Teven, C. M.; Disa, J. J.; Matros, E.; Cordeiro, P. G.; Mehrara, B. J.; Nelson, J. A.; Allen, R. J. Jr |
| Article Title: | Outcomes and perioperative risk factors after oncologic free-flap scalp reconstruction |
| Abstract: | Background Little is known about the risk factors associated with complications after free flap scalp reconstruction. The purpose of this study was to identify patient, scalp defect, and flap characteristics associated with increased risk of surgical complications. Methods A retrospective study was performed of free-flap scalp reconstruction in oncologic patients at Memorial Sloan Kettering Cancer Center from 2002 to 2017. Data collection included patient, defect, flap, and complication characteristics. Complications were classified into major, defined as complications requiring surgical intervention, and minor, defined as complications requiring conservative treatment. Risk factors and outcome variables were compared using chi-square with Fisher's exact test. Results A total of 63 free flaps to the scalp in 58 patients were performed; average follow-up was 3.5 years. Most flaps were muscle-only or musculocutaneous. One-third of patients with free flaps experienced complications (n = 21, 15 major and 6 minor). Examining risk factors for complications, patients with cardiovascular disease were nearly three times more likely to have suffered a major complication than patients without cardiovascular disease (36.7 vs. 12.1%, p = 0.04). This was the only significant risk factor noted. Perioperative radiotherapy, prior scalp surgery, flap type, and recipient vessel selection were found to be nonsignificant risk factors. Conclusion Cardiovascular disease may be a significant marker of risk for major complications in patients undergoing free-flap reconstruction of the scalp. This information should be used to help guide perioperative counseling and decision making in this challenging patient population. © 2022 Thieme Medical Publishers, Inc.. All rights reserved. |
| Keywords: | adult; aged; retrospective studies; major clinical study; hypertension; follow up; cohort analysis; risk factors; retrospective study; risk factor; postoperative complication; postoperative complications; graft failure; conservative treatment; cardiovascular disease; vein thrombosis; cardiovascular diseases; comorbidity; scalp; complications; perioperative period; free tissue graft; hematoma; seroma; wound healing impairment; artery thrombosis; skin injury; clinical outcome; free flap; free tissue flaps; cranioplasty; scalp reconstruction; humans; human; male; female; article; perioperative risk; skull defect |
| Journal Title: | Journal of Reconstructive Microsurgery |
| Volume: | 39 |
| Issue: | 7 |
| ISSN: | 0743-684X |
| Publisher: | Thieme Medical Publishers, Inc. |
| Date Published: | 2022-09-01 |
| Start Page: | 565 |
| End Page: | 572 |
| Language: | English |
| DOI: | 10.1055/a-2004-0196 |
| PUBMED: | 36577500 |
| PROVIDER: | scopus |
| PMCID: | PMC10387503 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Jonas A. Nelson -- Source: Scopus |
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