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Free Flap Outcomes for Head and Neck Surgery in Patients with COVID-19

Aaron Domack1, Morgan M Sandelski1, Syed Ali2

  • 1Department of Otolaryngology, Loyola University Medical Center, Maywood, Illinois, USA.

The Laryngoscope
|November 8, 2023
PubMed

Insights

Head and neck free flap reconstruction in patients with Coronavirus disease 2019 (COVID-19) showed low complication rates. Despite COVID-19

Area of Science:

  • Head and Neck Surgery
  • Vascular Surgery
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) is associated with vascular system complications and a hypercoagulable state.
  • This hypercoagulable state raises concerns for microvascular free flap reconstruction success.
  • Patients undergoing head and neck free flap reconstruction may face increased flap complications due to COVID-19.

Purpose of the Study:

  • To report perioperative head and neck free flap complications in patients with COVID-19.
  • To assess the impact of COVID-19 on free flap reconstruction outcomes.
  • To determine if COVID-19 increases the risk of flap-related complications.

Main Methods:

  • A multi-institutional retrospective case series.
  • Included patients undergoing head and neck free flap reconstruction between March 2020 and January 2022.
  • Collected data on COVID-19 status, surgical delays, flap complications, and other adverse events.

Main Results:

  • 40 patients from 14 institutions were analyzed.
  • 52.5% tested positive for COVID-19 within 10 days of surgery or 7 days post-surgery.
  • Only 5.0% experienced free flap complications, with no flap deaths. Surgical complications occurred in 10.0% and medical complications in 25.0%.

Conclusions:

  • Head and neck free flap reconstructions in COVID-19 patients did not demonstrate a higher risk of flap complications.
  • COVID-19 patients undergoing these procedures face an increased risk of medical complications.
  • The study suggests careful perioperative management is crucial for this patient group.
Abstract

Keywords:
COVID‐19coagulopathy in microvascular reconstructioncoronavirushead and neck reconstructionmicrovascular free flapsurgical complications in COVID‐19

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