Risk Factors for Free Flap Failure in Head and Neck Reconstruction: A Retrospective Analysis From a Single Medical...

Area of Science:

• Microsurgery
• Oncology
• Plastic Surgery

Background:

• Free flap reconstruction is crucial for head and neck cancer.
• Flap failure remains a significant complication despite high success rates.
• Identifying risk factors is essential for improving outcomes.

Purpose of the Study:

• To identify risk factors for flap failure in head and neck cancer reconstruction.
• To analyze real-world data from a single Taiwanese center.
• To provide data for surgical planning and patient counseling.

Main Methods:

• Retrospective analysis of 1015 patients undergoing free flap surgery (2013-2021).
• Inclusion of demographics, comorbidities, and treatment variables.
• Logistic and linear regression analyses to identify risk factors for flap failure and complications.

Main Results:

• Flap failure occurred in 3.19% of patients.
• Increased ischemia time significantly raised the risk of flap failure, complications, and longer hospital stays.
• Preoperative radiotherapy/chemotherapy correlated with higher complication rates and extended hospitalization, but not flap survival.

Conclusions:

• Ischemia time is a critical predictor of flap failure and prolonged hospitalization in head and neck cancer reconstruction.
• Preoperative radiotherapy or chemotherapy increases complications and hospital stay duration but does not impact flap survival.
• Findings support optimized surgical planning and patient counseling to mitigate risks in free flap procedures.