Intraoperative factors associated with free flap failure in the head and neck region: a four-year retrospective study of 216 patients and review of the literature

The aim of this study was to identify intraoperative factors associated with free flap failure. The outcomes of 216 patients (220 flaps) were analyzed retrospectively. A statistical analysis was performed to determine the association of flap failure with the intraoperative factors of prolonged operation time, flap type, vascular pedicle at the recipient site, and use of vasoactive medication. A review of the recent literature was also conducted to identify other intraoperative risk factors. Univariate regression analysis revealed that a prolonged operative time (P=0.013) and the vascular pedicle at the recipient site (P=0.027) were primary risk factors for flap failure.

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