Identification of Independent Risk Factors for Complications: A Retrospective analysis of 163 Fibular Free Flaps for Mandibulofacial Reconstruction

Publication date: Available online 8 January 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Haixuan WU, Funing Liu, Fengtao Ji, Mingyan Guo, Youyuan Wang, Minghui Cao
BackgroundFibular free flap transfer is a powerful tool available to the reconstructive surgeon when treating oral and maxillofacial defects, but complications still occasionally occur and predictive analysis focusing on this specific flap is limited in terms of risk factors for complication. The purpose of this study was to identify key variables associated with complications in patients undergoing fibular free flap transfer.MethodsThe data of 163 consecutive patients who underwent fibular free flap surgery at the Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, between 2012 and 2015, were reviewed retrospectively. Patient demographic data, laboratory data, surgical data and fluid infusion- related data that may have an influence on free flap outcomes were recorded. Univariate and multivariate logistic regression analysis were used to identify relevant risk factors.ResultsA total of 163 fibular free flaps were transferred for mandibulofacial reconstruction in 163 patients with a mean age of 50.9 years. 33 (20.2%) developed postoperative complications. Multivariate analysis revealed that free flap complications were significantly associated with radiotherapy history (odds ratio, OR=5.12, p=0.001), postoperative anemia (OR=1.048, p=0.041), postoperative hypoalbuminemia (OR=0.844, p=0.002), and prolonged operative time (OR=1.005, p=0.004).ConclusionRadiotherapy history, decreased postoperative hemoglobin and albumin level, and prolonged operative time are potential predictors of postoperative complications following fibular free flap reconstruction for mandibulofacial defect.



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