Postoperative inpatient surgical complications following head and neck microvascular free tissue transfer

Hasan Abdulbaki; Patrick K Ha; Philip D Knott; Andrea M Park; Rahul Seth; Chase M Heaton; Katherine C Wai

doi:10.1002/hed.27728

Postoperative inpatient surgical complications following head and neck microvascular free tissue transfer

Head Neck. 2024 Mar 6. doi: 10.1002/hed.27728. Online ahead of print.

Authors

Hasan Abdulbaki¹, Patrick K Ha², Philip D Knott², Andrea M Park², Rahul Seth², Chase M Heaton², Katherine C Wai²

Affiliations

¹ San Francisco School of Medicine, University of California, San Francisco, California, USA.
² Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA.

PMID: 38445792
DOI: 10.1002/hed.27728

Abstract

Background: Complications following head and neck microvascular free tissue transfer (MFTT) are common. Less is known about when they occur.

Method: Retrospective study of patients with primary or recurrent head and neck cancer undergoing MFTT reconstruction at a tertiary care institution. MFTT reconstructions with inpatient postoperative complications were included. The Kruskal-Wallis test was used to compare median postoperative day (POD) onset of complication by flap type.

Results: Of 1090 patients undergoing MFTT reconstruction, 126 (11.6%) patients experienced inpatient complications including fibula (n = 35), anterolateral thigh (n = 60), or radial forearm (n = 31) MFTTs. POD onset was shortest for surgical site hematoma (median = 1 [IQR 1-5]), and longest for donor site infection (median = 11.5 [IQR 8-15]). There was no significant difference between flap types and POD onset of complications (p > 0.05).

Conclusion: Hematoma formation and flap failure occur earliest during hospitalization, while dehiscence, infection, and fistula occur later. There is no difference in complication timing between flap types.

Keywords: complications; flap type; free flap; postoperative; timeline.