Free flap surgery in the elderly: Experience with 110 cases aged ≥70 years

Area of Science:

• Reconstructive surgery
• Geriatric surgery

Background:

• Free tissue transfer is a complex reconstructive procedure.
• Its application and outcomes in elderly patients (≥70 years) require specific evaluation.

Purpose of the Study:

• To evaluate the safety and efficacy of free tissue transfer in elderly patients.
• To identify predictors of complications in this demographic.

Main Methods:

• Retrospective review of 110 free tissue transfers in 104 patients aged ≥70 years over a 7-year period.
• Analysis of demographic, operative, and postoperative variables, including medical and surgical complications.
• Assessment of preoperative comorbidity using the ACE-27 index.

Main Results:

• Overall complication rate was 58% (64/110 procedures).
• Medical complications (25/110) were mainly pulmonary; surgical complications occurred in 54/110 cases.
• Successful flap transfer was achieved in 105/110 cases, with low operative mortality.
• Anesthetic duration predicted medical complications; ACE-27 score predicted recipient site complications.

Conclusions:

• Free tissue transfer can be performed with high technical success and low mortality in elderly patients.
• Chronological age alone should not preclude surgery; premorbid status is a critical factor.
• Minimizing general anesthesia duration is crucial for reducing postoperative medical complications.