Obesity and perioperative complications in head and neck free tissue reconstruction

Abstract

Background Free tissue transfer is a mainstay in reconstruction of complex head and neck defects. The purpose of this study was to determine if perioperative complications were more common in patients with body mass index (BMI) >30 kg/m2 undergoing free flap reconstruction. Methods A multi-institutional retrospective cohort was created. Medical complications, surgical complications, and procedural variables were recorded. Logistic regression was used to investigate univariate and multivariate associations between outcomes and predictors. Results Of 582 cases, 128 patients (22%) had BMI >30. Surgical complications occurred in 153 cases (26.3%), with an adjusted odds ratio (OR) for association of surgical complications with BMI >30 of 0.92 (p 5 .71). Medical complications occurred in 178 cases (30.6%), with an adjusted OR of 0.78 (p 5 .26). Age and advanced comorbidity status (Adult Comorbidity Evaluation-27 [ACE-27] 2 or 3) were associated with medical complications (p < .0001). Conclusion BMI >30 does not predict medical or surgical complications in patients undergoing head and neck free flap surgery.

Impact of Body Mass Index on Operative Outcomes in Head and Neck Free Flap Surgery

“…Therefore, these results are in agreement with existing reports specific to head and neck free flaps in finding no significant increase in operative morbidity in obese patients. 8,9 However, this analysis increases the validity of this conclusion, as comparisons were made to normal-weight controls rather than to all patients with nonobese BMI.…”

Risk factors for postoperative haemorrhage after total thyroidectomy: clinical results based on 2,678 patients

“…In a study aiming to analyse how BMI affects infectious complications in free tissue transfer surgery 20 , the authors failed to note a positive association, and a similar finding was also reported by de la Garza et al . 21 . However, both Lo et al .…”

Impact of diabetes on free flap surgery of the head and neck: A NSQIP analysis

“…A higher percentage of diabetic patients were found to have obesity, which is expected given the well‐known association between obesity and the development of insulin resistance (Kahn, Hull, & Utzschneider, ; Nguyen, Nguyen, Lane, & Wang, ). Interestingly, prior studies have shown that obesity may be associated with a decreased risk of head and neck cancer, and increased BMI is not a predictor of postoperative medical or surgical complications in patients undergoing head and neck free flap surgery (de la Garza et al, ; Tan et al, ).…”