Free flaps in elderly patients: Outcomes and complications in head and neck reconstruction after oncological resection

Ferrari, Silvano; Copelli, Chiara; Bianchi, Bernardo; Ferri, Andrea; Poli, Tito; Ferri, Teore; Sesenna, Enrico

doi:10.1016/j.jcms.2012.07.005

Cited by 100 publications

(118 citation statements)

References 21 publications

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“…This is in a line with data published by Ferrari et al, who showed that increasing age was not significantly associated with the incidence of postoperative complications. 17 In conclusion, microvascular free tissue transfer is a reliable and successful method of reconstruction in the head and neck, and is independent of the patient's age. However, one should carefully assess and investigate the patients' general health and coexisting conditions beforehand, and monitor flap perfusion carefully (particularly in patients previously treated with irradiation) to improve the postoperative outcome further and reduce the need for revision.…”

Section: Discussionmentioning

confidence: 87%

Perioperative factors that influence the outcome of microsurgical reconstructions in craniomaxillofacial surgery

Preidl

Wehrhan

Schlittenbauer

et al. 2015

British Journal of Oral and Maxillofacial Surgery

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Section: Discussionmentioning

confidence: 87%

Perioperative factors that influence the outcome of microsurgical reconstructions in craniomaxillofacial surgery

Preidl

Wehrhan

Schlittenbauer

et al. 2015

British Journal of Oral and Maxillofacial Surgery

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“…Many authors have mentioned that they chose the age cut-off arbitrarily (1,3,6,(12)(13)(14) Between 1996 and 2014, 30 patients over 70 who were operated on by using microsurgical techniques were extracted from patient records. Patient charts were reviewed retrospectively for demographics, risk factors, operative details, systemic/surgical complications, and mortality rates.…”

Section: Methodsmentioning

confidence: 99%

Microvascular tissue transfers in the elderly: safety analysis for a challenging area

et al. 2017

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Background/Aim: Due to increased average life expectancy, the number of elderly patients requiring complex reconstructive microsurgical procedures is rising. Age, comorbid conditions, and location of operation are all possible risk factors. The aim of this study is to evaluate surgical outcomes to set the right criteria.Materials and methods: Between 1996 and 2014, the data of 30 patients over the age of 70, who were treated with microsurgical techniques in our clinic, were extracted from patient records and analyzed retrospectively. Results:In this patient population, flap success rate was 94%. Systemic and surgical complication rates were 40% and 48%, respectively. Complication rates were higher in head and neck cases but there was no statistically significant difference compared to reconstructions in other areas. Loss of oral lining, as a serious complication, had no effect on complications in head and neck reconstruction patients in our series.Conclusions: Flap success is comparable to younger age groups but procedures are associated with a high rate of complications Evaluating and controlling comorbid conditions is important. The American Society of Anesthesiologists scoring system is reliable in this patient population. Although complications are more common, these procedures can be performed safely in elderly populations with careful patient selection.

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“…Between these 2 extremes, most authors used an age cutoff for the elderly between 65 and 75 years, [19][20][21][22][23][24][25] whereas the most commonly accepted definition of ''elderly'' uses 65 years as the age cutoff criterion. In a study by Beausang et al, 26 288 patients receiving intraoral free flaps were divided into 4 groups based on age: \50, 51-60, 61-70, and .70 years.…”

Section: Definition Of ''Elderly''mentioning

confidence: 99%

Free Flaps in Head and Neck Reconstruction after Oncologic Surgery

Grammatica

Piazza

Paderno

et al. 2015

Otolaryngol.--head neck surg.

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Microvascular reconstruction in the elderly can be performed with high success rates, even though medical complications can occur more frequently compared to younger patients. Minor and major surgical complications in the elderly appear to be comparable to those in the younger population and do not affect final outcome or the perioperative mortality rate. Flap outcome does not seem to be significantly affected by age. Careful preoperative assessment and postoperative monitoring are mandatory to prevent adverse events, and prompt management is warranted whenever present.

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Free flaps in elderly patients: Outcomes and complications in head and neck reconstruction after oncological resection

Cited by 100 publications

References 21 publications

Perioperative factors that influence the outcome of microsurgical reconstructions in craniomaxillofacial surgery

Perioperative factors that influence the outcome of microsurgical reconstructions in craniomaxillofacial surgery

Microvascular tissue transfers in the elderly: safety analysis for a challenging area

Free Flaps in Head and Neck Reconstruction after Oncologic Surgery

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