Outcomes of Microvascular Free Flap Reconstruction With One Versus Two Primary Surgeons.

Area of Science:

• Reconstructive surgery
• Head and neck surgery
• Microsurgery

Background:

• Head and neck free flap reconstruction is complex.
• Operative efficiency and quality are key metrics.
• Comparing single vs. multiple surgeons is important for optimizing outcomes.

Purpose of the Study:

• To compare operative efficiency and quality in head and neck free flap reconstruction using one versus two primary surgeons.
• To analyze procedure duration, hospital length of stay, complications, and readmission rates.

Main Methods:

• Retrospective chart review of 583 patients undergoing head and neck free flap reconstruction.
• Stratification into one-surgeon and two-surgeon cohorts.
• Analysis of patient demographics, American Society of Anaesthesia (ASA) status, and Charlson comorbidity index (CCI).

Main Results:

• The one-surgeon cohort had significantly reduced mean procedure duration (127.5 minutes shorter).
• No significant differences in baseline characteristics, hospital length of stay, or overall complications.
• Slightly higher proportion of osteocutaneous free flaps in the two-surgeon cohort.

Conclusions:

• Single primary surgeon-led head and neck free flap reconstruction demonstrates noninferior efficiency and quality.
• The optimal surgical approach may vary by institution and surgeon expertise.
• Further research can refine best practices for operative efficiency and patient outcomes.