Effect of Preoperative Medical Status on Microsurgical Free Flap Reconstructions: A Matched Cohort Analysis of 969 Cases

Journal of Reconstructive Microsurgery
Denis EhrlP Niclas Broer

Abstract

Free tissue transfers have become standard for a wide variety of reconstructive purposes. In an era of increasing economic pressure, it is important to precisely define appropriate candidates and indications for a complex surgery to optimize efficiency and patient outcomes. This study evaluates the feasibility to perform microsurgical procedures in a medically compromised patient cohort at a major academic microsurgical center. Within 7 years, 897 patients underwent 969 microvascular free flap reconstructions. The data were retrospectively screened for patients' demographics, perioperative details, flap survival, surgical complications, and outcomes. The cases were divided into two groups in "low-risk" (American Society of Anesthesiologists [ASA] I and II) or "high-risk" (ASA III and IV) as per the preoperative medical status classified according to the ASA score of physical status. Despite the significantly high prevalence of hypertension, peripheral artery disease, diabetes, obesity, and smoking status in the "high-risk" group (p < 0.05), there was no significant difference in the rate of surgical or medical complications, in operative times regarding overall as well as different flap entities, flap failures, need for revisio...Continue Reading

Citations

Aug 31, 2020·Journal of Reconstructive Microsurgery·Nicholas MoellhoffDenis Ehrl
Sep 3, 2020·Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deut·Nikolaus WachtelDenis Ehrl
Jan 27, 2019·Der Unfallchirurg·Denis EhrlChristian Zeckey
Jul 23, 2021·Journal of Plastic Surgery and Hand Surgery·Nicholas MoellhoffDenis Ehrl

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