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Risk Factors of Persistent Opioid Use After Forehead Flap Reconstruction.

Alexander J Barna1, Rahul K Sharma2, Nicole G DeSisto2

  • 1Drexel University College of Medicine, Philadelphia, PA, USA.

The Annals of Otology, Rhinology, and Laryngology
|January 7, 2026
PubMed
Summary
This summary is machine-generated.

Postoperative opioid prescriptions after forehead flap surgery increase the risk of persistent opioid use. Patients receiving opioids post-surgery were over three times more likely to develop new persistent opioid use.

Keywords:
facial reconstructionfacial traumaforehead flapopioidpedicled flap

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Area of Science:

  • Plastic Surgery
  • Pain Management
  • Opioid Use Disorder

Background:

  • Forehead flaps with preserved vascular pedicles are used in reconstructive surgery.
  • Persistent opioid use is a significant concern following surgical procedures.
  • Understanding risk factors for persistent opioid use is crucial for patient care.

Purpose of the Study:

  • To evaluate the association between early postoperative opioid prescriptions and the development of new persistent opioid use after forehead flap reconstruction.
  • To identify risk factors contributing to long-term opioid dependence in patients undergoing this specific surgical procedure.

Main Methods:

  • A multi-center cohort study utilizing the TriNetX US Collaborative Network.
  • Patients undergoing forehead flap reconstruction with vascular pedicle preservation were identified.
  • Propensity score matching was employed to control for confounding variables, and risk ratios were calculated to assess the likelihood of new persistent opioid use.

Main Results:

  • A total of 7214 patients were initially identified, with 2660 (36.9%) receiving a postoperative opioid prescription.
  • After propensity matching, 1352 patients were analyzed.
  • Patients prescribed opioids post-surgery had a 3.21 times greater risk of developing new persistent opioid use compared to those not prescribed opioids.

Conclusions:

  • Early postoperative opioid prescriptions following forehead flap reconstruction are associated with an increased risk of developing new persistent opioid use.
  • This finding highlights the importance of judicious opioid prescribing practices in the perioperative period for patients undergoing forehead flap surgery.
  • Further research may explore alternative pain management strategies to mitigate opioid dependence risk.