Abstract
Postoperative complications in head and neck surgery are well-known, but a predictive model to guide clinicians in free flap reconstructions has not been established. This retrospective single-center observational study assessed 131 patients who underwent ablative surgery and received free flap reconstruction. Primary endpoint was the occurrence of systemic complications (PSC). Secondary endpoint was the generation of a nomogram of complications according to the CDC classification. In the ordinal regression model, postoperative administration of furosemide [1.36 (0.63–2.11), p < 0.0001], blood loss [0.001 (0.0004–0.0020), p = 0.004], postoperative nadir hemoglobin [−0.03 (−0.07–0.01), p = 0.108], smoking [0.72 (0.02–1.44), p = 0.043], and type of flap reconstruction [1.01 (0.21–1.84), p = 0.014] as predictors. A nomogram with acceptable discrimination was proposed (Somer's delta: 0.52). Application of this nomogram in clinical practice could help identify potentially modifiable risk factors and thus reduce the incidence of postoperative complications in patients undergoing microvascular reconstruction of the head and neck.
Highlights
Free flap reconstruction in major head and neck surgery constitutes a high risk for the development of postoperative complications due to its complexity, with two or more distinct surgical sites and long procedure durations [1]
Reporting of Complications According to Postoperative Systemic Complications
This study highlights the high incidence of patients with postoperative systemic complications (PSCs) undergoing microvascular free tissue transfer in head and neck reconstruction
Summary
Free flap reconstruction in major head and neck surgery constitutes a high risk for the development of postoperative complications due to its complexity, with two or more distinct surgical sites and long procedure durations [1]. Patients undergoing this type of surgery are often of advanced age, are prone to overconsumption of alcohol and/or tobacco and show multiple comorbidities [2]. Risk Assessment for Head and Neck Reconstructions and systemic postoperative complications are difficult to identify because of the large number of influencing variables [3]. To assess the prognosis of diagnostic and treatment responses, nomograms are ideally suited to generate individual numerical probabilities for a clinical event for improved personalized medicine
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
