Related Experiment Video
Updated: Jun 21, 2026
A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery
Published on: November 8, 2019
Prospective analysis of outcomes and complications of 300 consecutive microvascular reconstructions
Michael J Nuara1, Cara L Sauder, Daniel S Alam
1Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Objective:
To prospectively follow up patients requiring microvascular reconstruction of head and neck defects to determine preoperative factors predictive of surgical complications.
Methods:
A prospectively collected database comprising 300 consecutive microvascular head and neck reconstructions performed by a single surgeon (D.S.A.) in a tertiary care hospital over a 6-year period was reviewed in a retrospective manner. Data collected included preoperative medical and surgical history (presence of documented cardiac disease, diabetes mellitus, and hypertension) and previous cancer treatment (surgery or radiation therapy). Postoperative data, including early or late complications, hematocrit during hospitalization, and functional status, were also collected. A multiple linear regression was used to identify predictors of surgical complications and secondarily crossed to determine the strength of the prediction. Statistical significance was set at P = .05.
Results:
Patients were stratified into 4 groups based on (1) previous radiation therapy, (2) previous surgery, (3) no previous radiation therapy or surgery, and (4) both previous radiation therapy and previous surgery, with an increased predictability of complications with both. Diabetes also added to the predictability of complications, with a smaller effect. Cardiac disease and hypertension were not predictive.
Conclusions:
Previous radiation therapy and surgery are positive predictors for wound complications after microvascular reconstruction. Diabetes may add further risk in this setting.
Insights
Previous radiation therapy and surgery increase surgical complication risks in head and neck microvascular reconstruction. Diabetes may also elevate these risks, impacting patient outcomes.
Area of Science:
- Reconstructive Surgery
- Oncology
- Plastic Surgery
Background:
- Microvascular reconstruction is crucial for head and neck defects.
- Identifying preoperative risk factors for complications is essential for improving patient outcomes.
Purpose of the Study:
- To identify preoperative factors that predict surgical complications in patients undergoing microvascular reconstruction for head and neck defects.
Main Methods:
- A retrospective review of 300 consecutive microvascular head and neck reconstructions.
- Data included patient history (cardiac disease, diabetes, hypertension) and prior cancer treatment (surgery, radiation).
- Multiple linear regression analysis was used to identify predictors of complications.
Main Results:
- Previous radiation therapy and surgery significantly increased the predictability of complications.
- Combined previous radiation therapy and surgery showed the highest predictability of complications.
- Diabetes Mellitus also predicted complications, though to a lesser extent.
- Cardiac disease and hypertension were not found to be predictive factors.
Conclusions:
- Previous radiation therapy and surgery are significant predictors of wound complications following microvascular reconstruction.
- Diabetes Mellitus may represent an additional risk factor in this patient population.
