Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as predictors of wound healing failure in head and neck reconstruction

Acta Otolaryngol. 2017 Jan;137(1):106-110. doi: 10.1080/00016489.2016.1218047. Epub 2016 Aug 24.

Abstract

Conclusions: In microsurgical head and neck reconstruction, a higher rate of post-operative wound complication could be predicted by a lower pre-operative neutrophil ratio (< 64.9%), neutrophil-lymphocyte ratio (NLR) (< 3.5), and platelet-lymphocyte ratio (PLR) (< 160).

Objectives: To evaluate the predictor of post-operative wound complications in microsurgical head and neck reconstruction.

Methods: Patients who were undergoing tumor ablation and microsurgical reconstruction from April 2011 to March 2014 were analyzed retrospectively. The pre-operative hematological data, age, sex, co-morbidities, body mass index (BMI), adjuvant therapies, smoking, operation time, blood loss, total protein, T-stage, and Anesthesiologists Performance Status (ASA-PS) score were collected. Cases of post-operative wound healing failure were reviewed.

Results: One hundred and three consecutive patients were enrolled. Among these, the results of 77 patients who were younger than 70 years of age were analyzed. The distributions of the neutrophil ratio (p = .0005), lymphocyte ratio (p = .0166), monocyte ratio (p = .0341), NLR (p = .005), and PLR (p = .008) differed significantly between the patients with and without post-operative wound healing failure. Neutrophil ratio, NLR, and PLR cut-off values of 64.9, 3.5, and 160 were significantly associated with the rate of wound healing failure rate (p = .0002, .00021, .0042, respectively).

Keywords: Surgical site infection; fistula; microsurgery; risk factor; wound healing.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Free Tissue Flaps*
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Lymphocyte Count
  • Male
  • Microsurgery
  • Middle Aged
  • Plastic Surgery Procedures
  • Postoperative Complications / immunology*
  • Retrospective Studies
  • Wound Healing / immunology*
  • Young Adult