Effect of renal dysfunction in free flap transfer for chronic wounds of the lower extremities

Hahn, Hyung Min; Jeong, Yon Soo; Lee, Il Jae; Kim, Min Ji; Lim, Hyoseob

doi:10.12790/ahm.22.0015

Cited by 2 publications

(3 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A retrospective study was conducted by Hahn et al from 2011 to 2020. The study evaluated 67 patients who underwent free tissue transfer procedures for chronic wounds in the lower‐extremity region (Hahn et al, 2022). The flap failure rate in all patients was 9%, and major complications were experienced by 16 patients (23.9%).…”

Section: Discussionmentioning

confidence: 99%

“…Our study showed a similar pattern of results, with one mortality case in the dialysis group, although the difference did not achieve significant level (7.7% vs. 0%, p = .085).A retrospective study was conducted byHahn et al from 2011Hahn et al from to 2020. The study evaluated 67 patients who underwent free tissue transfer procedures for chronic wounds in the lower-extremity region(Hahn et al, 2022). The flap failure rate in all patients was 9%, and major complications were experienced by 16 patients (23.9%).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Microsurgical reconstruction for head and neck in patients with end‐stage renal disease undergoing dialysis

Hung,

Wu,

Wang

et al. 2024

Microsurgery

View full text Add to dashboard Cite

IntroductionFree flap transfer for head and neck defects has gained worldwide acceptance. Because flap failure is a devastating outcome, studies have attempted to identify risk factors—including renal failure. We sought to determine whether end‐stage renal disease (ESRD) patients undergoing dialysis are at increased risk of flap failure following microsurgical head and neck reconstruction.Patients and MethodsThe study's participants were patients who underwent free flap reconstruction in the head and neck region at Hualien Tzu Chi Hospital between January 2010 and December 2019. We used the National Health Insurance “Specific Diagnosis and Treatment Code” to identify patients undergoing dialysis; these patients comprised the dialysis group, whose members were matched to a non‐dialysis group for age and gender. The dependent variables were flap survival rate, take‐back rate, and flap failure risk between the dialysis and non‐dialysis groups.ResultsWe included 154 patients in the dialysis (n = 14) and non‐dialysis (n = 140) groups. The groups were similar in terms of age and most comorbidities, except diabetes mellitus, hypertension, and coronary artery disease, which were more prevalent in the dialysis group. The dialysis and non‐dialysis groups had similar flap survival rates (100% vs. 92.9%; p = .600). Twenty‐three patients underwent take‐back surgery, most in the non‐dialysis group (14.3% vs. 15.0%; p = 1.000). Patients in the dialysis group were more likely to have prolonged intensive care unit stays; however, dialysis alone did not predict flap failure (OR: 0.83; p = .864).ConclusionThis study found no significant differences in free flap survival and take‐back rates between patients with and without dialysis. Dialysis did not increase the risk of flap failure following microsurgical head and neck reconstruction in this study; however, prospective, randomized controlled trials are needed.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Microsurgical reconstruction for head and neck in patients with end‐stage renal disease undergoing dialysis

Hung,

Wu,

Wang

et al. 2024

Microsurgery

View full text Add to dashboard Cite

show abstract

“…They had an immediate flap failure rate of 6% with an overall rate of post‐operative complications of 44% 11 . Hahn et al also looked at free tissue transfers for chronic wounds of the lower extremities and found a direct correlation between free flap failure and ESRD and renal transplantation patients, with a flap failure rate of 9% and a complication rate of 23.9% 12 . It is important to note that most of these patients were undergoing reconstruction for lower limb ischemia due to other medical co‐morbidities, most prevalently diabetes and peripheral vascular disease.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Head and Neck Free Tissue Transfer in Renal Failure Patients

et al. 2023

View full text Add to dashboard Cite

ObjectiveTo assess if there is increased risk of free flap failure in renal failure patients undergoing head and neck reconstruction. We seek to primarily assess free flap outcomes based on stages of chronic kidney disease (CKD) and secondarily determine increased risk for postoperative complications.MethodsRetrospective chart review was performed at five tertiary care centers. Patients were identified that had undergone microvascular free flap reconstruction of the head and neck with diagnosis of renal failure, classified as Stage 3 CKD or higher. Demographic data was collected. Outcomes in the postoperative period were examined.ResultsSeventy‐three patients met inclusion criteria. The average patient age was 69 years with a male predominance (n = 48). The majority of patients had CKD Stage 3 (n = 52). Overall flap failure rate was 12.33% (n = 9, CKD stage 3 = 7.69%, CKD stage 4 = 30%, CKD stage 5 = 18%). There was an increased risk of flap failure on multivariate analysis for CKD stage 4/5 patients when compared to CKD 3 patients (p = 0.0095). When compared to matched controls, there was an increased risk of flap failure in CKD patients (p = 0.01) as well as an increased risk of overall complications (p < 0.0001).ConclusionsPatients with CKD undergoing head and neck reconstruction are at a higher risk of flap failure and overall complications. When comparing CKD stages there may be increased risk of flap failure in later stages of CKD compared to CKD 3. Appropriate patient counseling is recommended pre‐operatively in this patient population with consideration for regional flaps in the appropriate patient.Level of EvidenceIII Laryngoscope, 2023

show abstract

Effect of renal dysfunction in free flap transfer for chronic wounds of the lower extremities

Cited by 2 publications

References 23 publications

Microsurgical reconstruction for head and neck in patients with end‐stage renal disease undergoing dialysis

Microsurgical reconstruction for head and neck in patients with end‐stage renal disease undergoing dialysis

Outcomes of Head and Neck Free Tissue Transfer in Renal Failure Patients

Contact Info

Product

Resources

About