Gordon F Z Tsang1, Han Zhang2, Christopher Yao3, Mirko Kolarski3, Patrick J Gullane2, Jonathan C Irish2, Dale H Brown2, Douglas B Chepeha2, David P Goldstein2, Ralph W Gilbert2, John R de Almeida4. 1. Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Hospital Network, Toronto, Ontario, Canada; Department of Otolaryngology-Head & Neck Surgery, Toronto, Ontario, Canada. Electronic address: gord.tsang@mail.utoronto.ca. 2. Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Hospital Network, Toronto, Ontario, Canada. 3. Department of Otolaryngology-Head & Neck Surgery, Toronto, Ontario, Canada. 4. Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Hospital Network, Toronto, Ontario, Canada. Electronic address: john.dealmeida@uhn.ca.
Abstract
BACKGROUND: Despite improvements in surgical technique and technology, hardware complications occur relatively frequently. This study analyzes hardware complications in patients undergoing oromandibular reconstruction using scapular (SFF) or fibular (FFF) free flaps. METHODS: Retrospective data for 178 patients was obtained (1999-2014) at University Hospital Network (Toronto, Canada). Univariable and multivariable analyses were performed to identify risk factors for hardware complications. RESULTS: Patients with FFF reconstruction (n=129) had significantly more hardware complications than those with SFF (n=49) (16% vs. 2%;p=0.01). Surgical site infection (SSI) (OR=7.05; p<0.01), defect type (OR=2.63; p<0.01) and flap (OR=0.12; p=0.01) were significant predictors of hardware complications on univariable analysis. Flap type (OR=0.12; p=0.04) was an independent predictor of plate complication after adjusting for SSI. A subgroup analysis suggested a trend towards fewer hardware complications with SFF stratified by mandibular defect type. CONCLUSIONS: Scapular free flaps are associated with a lower rate of hardware-related complications in oromandibular reconstruction.
BACKGROUND: Despite improvements in surgical technique and technology, hardware complications occur relatively frequently. This study analyzes hardware complications in patients undergoing oromandibular reconstruction using scapular (SFF) or fibular (FFF) free flaps. METHODS: Retrospective data for 178 patients was obtained (1999-2014) at University Hospital Network (Toronto, Canada). Univariable and multivariable analyses were performed to identify risk factors for hardware complications. RESULTS:Patients with FFF reconstruction (n=129) had significantly more hardware complications than those with SFF (n=49) (16% vs. 2%;p=0.01). Surgical site infection (SSI) (OR=7.05; p<0.01), defect type (OR=2.63; p<0.01) and flap (OR=0.12; p=0.01) were significant predictors of hardware complications on univariable analysis. Flap type (OR=0.12; p=0.04) was an independent predictor of plate complication after adjusting for SSI. A subgroup analysis suggested a trend towards fewer hardware complications with SFF stratified by mandibular defect type. CONCLUSIONS: Scapular free flaps are associated with a lower rate of hardware-related complications in oromandibular reconstruction.
Authors: Nikhil Sobti; Kaleem S Ahmed; Thais Polanco; Marina Chilov; Marc A Cohen; Jay Boyle; Farooq Shahzad; Evan Matros; Jonas A Nelson; Robert J Allen Journal: J Plast Reconstr Aesthet Surg Date: 2022-05-06 Impact factor: 3.022
Authors: Amit Walia; Joshua Mendoza; Craig A Bollig; Ethan J Craig; Ryan S Jackson; Jason T Rich; Sidharth V Puram; Sean T Massa; Patrik Pipkorn Journal: Laryngoscope Date: 2021-02-11 Impact factor: 2.970
Authors: Catherine T Haring; Emily J Marchiano; Jayne R Stevens; Kelly M Malloy; Keith A Casper; Mark E Prince; Steven B Chinn; Chaz L Stucken; Andrew J Rosko; Matthew E Spector Journal: Plast Aesthet Res Date: 2021-07-04
Authors: Akina Tamaki; Shruthi Sethuraman; Lucy Shi; Songzhu Zhao; Keith C Carver; Angel Hatef; Michael Luttrull; Nolan B Seim; Stephen Y Kang; Enver Ozer; Amit Agrawal; Matthew O Old Journal: OTO Open Date: 2022-01-12