Factors influencing early postsurgical mobilization following Vascularized Iliac Crest Flap for jaw defect reconstruction

Abstract

Objectives/hypothesisEarly mobility following vascularized iliac flap (VIF) may be influenced by several factors. This study evaluated early mobility and factors influencing patient mobilization following VIF. Study designProspective observational study MethodsWe recruited 115 inpatients who underwent VIF surgery for jaw defect reconstruction at our hospital. Sociodemographic, clinical, and Tinetti test data were analyzed using univariate and multiple logistic regression. Receiver operating characteristics (ROC) curves were used to analyze factors hindering early mobilization. ResultsThe proportion of patients who could sit up on POD2 and walk on POD3 was 61.74% and 56.52%, respectively. The mean Tinetti score at discharge was 9.56 ± 4.27 (range, 3–22). Logistic regression analysis revealed five significant indicators associated with delayed mobilization: pain (odds ratio [OR] = 0.396, p = 0.010), soft tissue flap area (OR = 0.818, p = 0.012), length of bone harvested (OR = 0.443, p = 0.009), and fatigue (OR = 0.449, p = 0.030). The area under the ROC curve for the five indicators was 0.964, with a cutoff value of 22.108, sensitivity of 0.940, specificity of 0.846, and Youden's index of 0.786. The length of bone harvested (B = −0.696, p < 0.001), soft tissue flap area (B = −0.103, p = 0.039), and fatigue (B = −0.628, p = 0.009) influenced the Tinetti test at discharge. ConclusionsMore than half of the patients could be mobilized early. Pain significantly influenced mobilization progress, followed by soft tissue flap area, length of bone harvested, and fatigue.