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01-05-2019 | Original Article

Postoperative morbidity of free flaps in head and neck cancer reconstruction: a report regarding 215 cases

Authors: Maria Poisson, Julie Longis, Matthias Schlund, Morgane Pere, Guillaume Michel, Antoine Delagranda, François Mouawad, Benoit Piot, Hélios Bertin

Published in: Clinical Oral Investigations | Issue 5/2019

Abstract

Objectives

The aim of this study was to identify the factors responsible for free flap failure, the surgical complications, and the non-oral feeding period in patients treated for an oral squamous cell carcinoma.

Materials and methods

This multicentric study included 215 patients treated by tumour resection with immediate free flap reconstruction for an OSCC between 2010 and 2016. All of the patient medical files were reviewed and the data regarding the patient medical history, the tumour-related features, the surgical procedure, and the postoperative recovery were compiled. A statistical analysis with univariate and multivariate logistic regression was carried out.

Results

The free flap success rate was 94.4% in our series. A postoperative complication occurred in 101 patients (41%). Minor surgical complications were shown to increase the free flap failure rate (OR 3.32; p = 0.04). A major surgical complication was encountered in 48 patients (22.3%), and these were linked to minor surgical complications (OR 2.89; p = 0.004) and the use of a tracheostomy (OR 5.76, p = 0.002). Conversely, a medical history of high blood pressure had a protective effect (p = 0.04). The non-oral feeding rate at the end of the hospital stay was 28.4%, and it correlated with the tracheostomy (p = 0.002), as well as the major and the minor surgical complications (p = 0.04).

Conclusion-clinical relevance

Free flap reconstruction is a safe and reliable technique with head and neck cancer reconstruction. Postoperative care favouring early and safe oral-feeding, and avoiding a tracheostomy can reduce the incidence of surgical complications after OSCC reconstruction.

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Title: Postoperative morbidity of free flaps in head and neck cancer reconstruction: a report regarding 215 cases
Authors: Maria Poisson
Julie Longis
Matthias Schlund
Morgane Pere
Guillaume Michel
Antoine Delagranda
François Mouawad
Benoit Piot
Hélios Bertin
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 5/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-018-2653-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Postoperative morbidity of free flaps in head and neck cancer reconstruction: a report regarding 215 cases

Abstract

Objectives

Materials and methods

Results

Conclusion-clinical relevance

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion-clinical relevance

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