Postoperative symptoms burden in free flap reconstruction of head and neck: a qualitative study

Abstract

Objectives: To find the significant risk factors associated with delayed complications in free fibula reconstruction of mandible. Methods: A retrospective cohort of patients who received vascular fibula reconstruction for mandible from January 2011 to December 2013 were charted. Clinical, pathological and therapeutic factors were analysed for delayed complications in univariate and multivariate analysis to find the significance. Findings: A total of 142 patients were analysed; the median follow-up period was 47 months. There were total of 19 patients with the late complications. The median time of complications was 8 months after surgery. Preoperative or postoperative radiotherapy were significant factors (0.02) and preoperative with postoperative irradiation was highly associated with the complication (75%, P = 0.002). The type of Ti plate used for fixation was a significant factor (P = 0.019), the disease characteristics (P = 0.02) was a significant factor. The multivariable Cox regression showed postoperative radiation (odds 6.9, P = 0.009) and history of smoking (odds 4.3, 0.037) as significant factors for late complications Conclusion: Postoperative radiation and smoking history are associated with late complications in fibula reconstruction of mandible and a caution is needed in selecting such patients for endosseous implants.