Hypoalbuminemia in Microsurgical Flaps of the Musculoskeletal Apparatus

Abstract

Objective: To evaluate if the levels of serum total protein and serum albumin are risk factors for surgical complications of free flap limb reconstruction. Methods: Consecutive inclusion of all patients undergoing microsurgical flaps for limb reconstruction of complex injuries. We recorded epidemiological and laboratory data, including total proteins and fractions, for descriptive and analytical statistics. Results: Our study analyzed one microsurgical flap from 35 patients that underwent complex injuries of the limbs. In total, 23 patients were men, and mean age of all patients was 35 years. After statistical analysis, no influence of pre or postoperative hypoalbuminemia was observed on the incidence of complications. Patients with hypoalbuminemia had a higher length of stay than those with normal albumin levels (p = 0.008). Conclusion: We observed that 71% of patients had hypoalbuminemia in early postoperative period and we suggest a nutritional support for patients requiring complex traumatic limb reconstruction. Hypoalbuminemia in patients subjected to microsurgical flaps for the treatment of complex traumatic limb injuries did not influence the complications that required surgical reintervention; However, it was associated with prolonged hospital stay. Level of Evidence II, Retrospective study.

Serum Albumin Kinetics in Major Ovarian, Gastrointestinal, and Cervico Facial Cancer Surgery

“…With regard to major cancer ENT surgery, our data are in accordance with a previous study on complex traumatic limb injury patients and hypoalbuminemia in patients having microsurgical flaps for treatment of their injuries. This did not influence the occurrence of complications that required surgical re-intervention; however, it was associated with prolonged hospital stay [ 22 ]. Another important issue is the DBK group which obviously considered only female patients which could influence the overall albumin concentrations [ 23 ], but since we considered only the percentage of decrease, we believe this would not affect our results and conclusions.…”

Malnutrition in Head and Neck Free Flap Reconstruction as a Predictor of Adverse Outcomes

“…13 Furthermore, patients with hypoalbuminemia who had undergone microvascular flap transfer for limb reconstruction experienced significantly longer hospital stays (28.6 days) in comparison to those with normal serum albumin levels (9.8 days). 14 Despite a recent rise in the literature on modifiable risk factors in H&N free flap reconstruction, there remains a paucity of research specifically concerning the use of albumin levels as a predictor of poorer surgical outcomes. The aim of this study is to investigate the impact of preoperative hypoalbuminemia on the risk of adverse postoperative outcomes in H&N free flap reconstruction using a large administrative dataset.…”

“…The use of serum albumin as an indicator of nutritional status has been suggested as more reliable than other preoperative quantifiers; in fact, serum albumin level among 62 preoperative variables in 54,215 major surgery cases had the strongest association with mortality (c index = 0.78) 13 . Furthermore, patients with hypoalbuminemia who had undergone microvascular flap transfer for limb reconstruction experienced significantly longer hospital stays (28.6 days) in comparison to those with normal serum albumin levels (9.8 days) 14 …”