2020, Number 3
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Cir Plast 2020; 30 (3)
Prognostic factors associated to flap failure
Zúñiga-Garza E, Cruz-Reyes S, Flores-Álvarez E
Language: Spanish
References: 16
Page: 144-148
PDF size: 224.62 Kb.
ABSTRACT
The indications for making a flap are varied, when analyzed the technique is always emphasized. However, there is little literature related to factors associated with flap failure. The objective of this work was to identify the factors associated with flap failure in patients operated in the Miguel Hidalgo Centennial Hospital. We reviewed the clinical records of the hospital to identify patients over 17 years of age who underwent surgery and had a flap made in the period from June 2013 to July 2019. It included a total of 124 patients: 69 women (55.6%) and 55 men (44.4%), with an age average of 56.5 ± 19.7 years. Flap viability was demonstrated in 117 patients (94.4%) and 7 flaps (5.6%) were non-viable. Twenty-nine patients presented complications, dehiscence being the most common. We conclude that in our study the factors associated with flap failure are lymphopenia (p = 0.04) (OR 3.060) and smoking (p = 0.03) (OR 2.460).
REFERENCES
Thorne CH, Chung KC, Gosain AK, Gurtner GC, Mehrara BJ, Rubin JP et al. Grabb and Smith's plastic surgery, Seventh edition. Wolters Kluwer Health Adis, 2013.
Tschoi M, Hoy EA, Granick MS. Skin flaps. Clin Plast Surg 2005; 32 (2):261-273.
Harashina T. Analysis of 200 free flaps. Br J Plast Surg 1988; 41 (1): 33-36.
Arita-Zelaya AC, Fierro-Arias L, Arellano-Mendoza I, Ponce-Olivera RM, Peniche Castellanos A. Frecuencia de factores de riesgo y etiología de infecciones postquirúrgicas en cirugía dermatológica, Hospital General de México. Rev Med Hosp Gen Mex 2009; 72 (3): 136-141.
Nolan J, Jenkins RA, Kurihara K, Schultz RC. The acute effects of cigarette smoke exposure on experimental skin flaps. Plast Reconstr Surg 1985; 75 (4): 544-551.
Chang LD, Buncke G, Slezak S, Buncke HJ. Cigarette smoking, plastic surgery, and microsurgery. J Reconstr Microsurg 1996; 12 (07): 467-474.
Sushruta S. An english translation of the Sushruta Samhita based on original Sanskrit text. 1963.
Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. J Plast Reconstr Aesthet Surg 1987; 40 (2): 113-141.
Patel KG, Sykes JM. Concepts in local flap design and classification. Op Tech Otolaryngol Head Neck Surg 2011; 22 (1): 13-23.
Kerrigan CL. Skin flap failure: pathophysiology. Plast Reconstr Surg 1983; 72 (6): 766-777.
World Health Organization. Hemoglobin concentrations for the diagnosis of anemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization, 2011.
Young GA, Hill GL. Assessment of protein-calorie malnutrition in surgical patients from plasma proteins and anthropometric measurements. Am J Clin Nut 1978; 31 (3): 429-435.
Brunetti B, Barone M, Tenna S, Salzillo R, Segreto F, Persichetti P. Pedicled perforator-based flaps: Risk factor analysis, outcomes evaluation and decisional algorithm based on 130 consecutive reconstructions. Microsurgery 2020; 40 (5): 545-552.
Bozikov K, Arnez ZM. Factors predicting free flap complications in head and neck reconstruction. J Plast Reconstr Aesthet Surg 2006; 59 (7): 737-742.
Crawley MB, Sweeny L, Ravipati P, Heffelfinger R, Krein H, Luginbuhl A et al. Factors associated with free flap failures in head and neck reconstruction. Otolaryngol Head Neck Surg 2019; 161 (4): 598-604.
Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control 1999; 27 (2): 97-132.