Postoperative complications after major head and neck surgery with free flap repair—prevalence, patterns, and determinants: a prospective cohort study

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

“…There are also other tools such as the Adult Comorbidity Evaluation-27 index (ACE-27) or the Eastern Cooperative Oncology Group (ECOG) which have been found to be useful in prospectively evaluating patients' risk of complications in microvascular free tissue reconstructions. 16 Surprisingly, although the ASA grade was significantly associated with increasing age in our analysis, the number of revisions and failures of flaps was not related to the age of the patient. 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.…”

Is benchmarking possible in audit of early outcomes after operations for head and neck cancer?

“…Authors of another series on free flap reconstruction of the head and neck for SCC ablative defects reported 22% severe complications (Clavien Dindo over 2). 4 We report 19% severe complications (for all units) when only patients (n = 172) who had free tissue transfer were included. However, these comparisons are limited in value because it is not possible to adjust for case mix.…”

Invasive basosquamous cell carcinoma of the head treated with wide excision and reconstruction with fascia lata graft and two muscle flaps. Case report

“…PO complications after major head and neck surgery (involving free flaps) include medical complications and those related to donor and recipient site [41][42][43]. Most frequent major complications are respiratory failure and pneumonia.…”

“…Perisanidis et al reviewed 79 patient who underwent major head and neck surgery: 43% had pulmonary complications, from which 9% with respiratory failure [41]. McMahon et al report 8 cases of delirium out of 192 patients [42]. A frequent minor complication reported in the literature is the need for transfusion, as Perisanidis et al reported in 39% cases [43].…”

“…In a retrospective study on 282 patients who underwent head and neck surgery with free flap reconstructions, there was no statistical difference in flap failure rate between patient with transfusion vs. no transfusion group. [44] The risk factors related with PO complications are the area of surgery, neck dissection, operating time, comorbidities and alcohol consumption [41,42]. Herein, the patient developed PO pneumonia, posthemorrhagic anemia, and withdrawal syndrome, remitted under specific treatment.…”