Microvascular histopathology in head and neck oncology

Stavrianos, S.; McLean, N.R.; Fellows, S; Hodgkinson, Peter; Kostaki, Anastasia K.; Kelly, Cynthia M.; Soames, J.V.

doi:10.1016/s0007-1226(03)00024-9

Cited by 20 publications

(16 citation statements)

References 14 publications

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“…The influence of smoking on thrombosis during or after microvascular reconstructive procedures with free-flaps in the head and neck has not been studied extensively, although its contribution to general complications is well known 6,14,17,20,36,38 . Smoking plays a part in the incidence of delayed wound healing in general, but is not a proven risk factor for head and neck free-flap failure in specific (Table 4) 6,14,17,20,36,38 .…”

Section: Discussionmentioning

confidence: 99%

“…Several studies show that previous radiotherapy has no significant influence in free-flap failure but is a significant risk factor in complications such as delayed wound healing (Table 5) 3,6,12,14,15,20,24,28,31,36,37 , but other studies contradict this 14,24,31,33 . These differences could also be explained by differences in indications for microvascular reconstructive free-flap surgery.…”

Section: Discussionmentioning

confidence: 99%

“…These conditions, such as diabetes mellitus, advanced atherosclerosis or other cardiovascular diseases influence the incidence of complications and are likely to impair the quality of the vessel wall and wound healing in general 5,27,36,38 . Factors such as old age and the presence of tumour are considered to be risk factors for venous thrombolytic events 19 .…”

mentioning

confidence: 99%

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Prevention of thrombosis after microvascular tissue transfer in the head and neck. A review of the literature and the state of affairs in Dutch Head and Neck Cancer Centers

Brands

Bosch

Dieleman

et al. 2010

International Journal of Oral and Maxillofacial Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prevention of thrombosis after microvascular tissue transfer in the head and neck. A review of the literature and the state of affairs in Dutch Head and Neck Cancer Centers

Brands

Bosch

Dieleman

et al. 2010

International Journal of Oral and Maxillofacial Surgery

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“…The improvement in temperature observed with the use of a very simple and easily used medication is even more interesting and challenging. The combination of the improvement of the risk factors with a medical intervention and the subsequent improvement of the microcirculation, and finally ulceration healing, need to be confirmed with further experimental and clinical research.Finally, methods of measuring microcirculation in which provide quantitative as well as qualitative data, such as laser Doppler, plethysmography and ICG laser angiography in real time fluorescent imaging, have much to offer to research and clinical practice in this field [3,4]. …”

mentioning

confidence: 99%

“…Finally, methods of measuring microcirculation in which provide quantitative as well as qualitative data, such as laser Doppler, plethysmography and ICG laser angiography in real time fluorescent imaging, have much to offer to research and clinical practice in this field [3,4]. …”

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confidence: 99%

Complex venous pathophysiology: Think simple

Stavrianos¹

2017

Hellenic J Surg

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Microcirculation and anatomy are the two basic principles that we plastic surgeons are continuing to study throughout our professional life.Basic anatomy rules we have to apply to all our reconstructions, and then we have to anticipate restoration of the circulation, and especially the microcirculation changes and establishment, to define success.These microcircuits are anatomically defined by the arteriole, the venule and the capillaries and they are influenced by several factors, including O2 radicals, changes in temperature, pH and CO2, medications, inflammation and local or systemic sepsis, and other conditions less clearly defined.The reperfusion phenomenon is a complication that occurs after cessation and rapid restoration of the circulation in a transplant,often with catastrophic consequences.In addition, extremity soft tissue ulcers are due to faulty microcirculation.It is therefore extremely useful to try to recognize risk factors, and especially to measure the factors known to be responsible for microcirculation changes, such as the temperature.In this issue Katseni et al [1,2] very nicely evaluate temperature changes in patients suffering from leg ulcerations of different remote etiology. The improvement in temperature observed with the use of a very simple and easily used medication is even more interesting and challenging. The combination of the improvement of the risk factors with a medical intervention and the subsequent improvement of the microcirculation, and finally ulceration healing, need to be confirmed with further experimental and clinical research.Finally, methods of measuring microcirculation in which provide quantitative as well as qualitative data, such as laser Doppler, plethysmography and ICG laser angiography in real time fluorescent imaging, have much to offer to research and clinical practice in this field [3,4].

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Association between hypertension requiring medication and 30‐day outcomes in head and neck microvascular surgery

et al. 2021

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Background Hypertension has been shown to be both a protective factor and a risk factor for complications in head and neck reconstructive surgery. Methods Retrospective analysis of microvascular free tissue transfer patients using the National Surgical Quality Improvement Program database. Results Hypertensive patients (n = 1598; 46.9%) had a significantly higher rate of complications, including pneumonia (p < 0.001), myocardial infarction (p = 0.003), and intra/post‐operative transfusion (p < 0.001). In a multivariable model, hypertension was associated with returning to the operating room (OR = 1.45 [95% CI 1.20, 1.76], p < 0.001), post‐operative medical complications (OR = 1.53 [95% CI 1.24, 1.90], p < 0.001), and surgical complications (OR = 1.17 [95% CI 1.00, 1.37], p = 0.047). However, no difference in 30‐day readmission was found (p > 0.05). Conclusions Hypertension is a modifiable risk factor for post‐operative complications in head and neck free tissue transfer, in which prospective studies are required to establish causation. This study may serve as an impetus for proactive recommendations to manage hypertension before undergoing head and neck microvascular surgery.

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Microvascular histopathology in head and neck oncology

Cited by 20 publications

References 14 publications

Prevention of thrombosis after microvascular tissue transfer in the head and neck. A review of the literature and the state of affairs in Dutch Head and Neck Cancer Centers

Prevention of thrombosis after microvascular tissue transfer in the head and neck. A review of the literature and the state of affairs in Dutch Head and Neck Cancer Centers

Complex venous pathophysiology: Think simple

Association between hypertension requiring medication and 30‐day outcomes in head and neck microvascular surgery

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