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Healing II: Complications

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Updated: May 5, 2026

In situ Transverse Rectus Abdominis Myocutaneous Flap: A Rat Model of Myocutaneous Ischemia Reperfusion Injury

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When a Good Flap Turns Bad: A Temporal Predictive Model for Free Flap Complications.

Dylan K Kim¹, Seth Z Aschen¹, Christine H Rohde¹

¹Division of Plastic and Reconstructive Surgery, Columbia University Irving Medical Center, New York, New York.

Journal of Reconstructive Microsurgery

|March 28, 2024

Summary

Complications after microsurgery increase the risk of adverse outcomes. Early complications and reoperation timing significantly predict future issues, impacting reconstructive success.

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Last Updated: May 5, 2026

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A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery

Published on: November 8, 2019

Area of Science:

Plastic Surgery
Microsurgery Outcomes
Surgical Complications

Background:

Microsurgical procedures are complex plastic surgery cases with high risks of postoperative complications.
Understanding the timeline and impact of these complications is crucial for improving reconstructive outcomes.

Purpose of the Study:

To investigate the temporal progression of complications following microsurgical procedures.
To assess the risk of acute postoperative complications on subsequent reconstructive results.

Main Methods:

Utilized the National Surgical Quality Improvement Program database for microsurgery cases.
Analyzed 30-day postoperative complications stratified into four temporal periods (PODs 0-6, 7-13, 14-20, 21-30).
Employed multivariate logistic regression to identify predictors of adverse outcomes and reoperation.

Main Results:

Over 19,500 patients analyzed; 31.5% experienced complications within 30 days.
Prior complications significantly predicted future adverse outcomes, especially after the first week (p < 0.001).
Reoperation within two weeks occurred in 13.2% of patients; reoperation indication and timing were key predictors (p < 0.001).

Conclusions:

Early postoperative complications are significant predictors of later adverse events.
The timing and reason for reoperation are critical factors influencing future complications after microsurgery.