Impact of increasing operative time on the incidence of early failure and complications following free tissue transfer? A risk factor analysis of 2,008 patients from the ACS‐NSQIP database

Abstract

Our results, one of the largest series in the literature, revealed that prolonged operative time was associated with a stepwise increase in the likelihood of early flap failure as well certain postoperative complications. © 2014 Wiley Periodicals, Inc. Microsurgery 37:12-20, 2017.

Analysis of Risk Factors for Unplanned Reoperation Following Free Flap Surgery of the Head and Neck

“…Additional factors found to be independently associated with unplanned reoperation, such as prior wound infection, surgical site infection, and prolonged ventilation, are also consistent with previous literature as being related to free flap complications . Furthermore, another important finding from our study is the lack of significant association of reoperation with ASA classification.…”

Use of free tissue transfer in head and neck cancer surgery and risk of overall and serious complication(s): An American College of Surgeons-National Surgical Quality Improvement Project analysis of free tissue transfer to the head and neck

“…Prolonged operative time was associated with early flap failure and several medical complications (pneumonia, blood transfusions, prolonged ventilation, wound dehiscence, and wound complications) in a recent NSQIP query. 10 Taken together, these studies and the present one suggest that faster surgery is best for flap cases in the head and neck.…”

Association between operation‐ and operator‐related factors and surgical complications among patients undergoing free‐flap reconstruction for head and neck cancers: A propensity score‐matched study of 1,865 free‐flap reconstructions

“…Microvascular free‐flap transfer has become a standard procedure for complex defect coverage and reconstruction after head and neck cancer resection. Surgical techniques have undergone many developments that have made free‐flap reconstruction a safe and effective procedure, with a success rate of 91–99% (Bui et al, ; Mucke et al, ; Offodile 2nd, Aherrera, Wenger, Rajab, & Guo, ). However, due to the complex nature and long operative time of the procedure, as well as the underlying medical issues in these patients, the patients are subjected to the development of surgical complications, such as infection, hematoma, wound disruption, fistula, pedicle thrombosis, partial flap gangrene, and total flap loss.…”