Free Flap Outcomes for Head and Neck Surgery in Patients with COVID-19.

Autor: Domack A; Department of Otolaryngology, Loyola University Medical Center, Maywood, Illinois, USA., Sandelski MM; Department of Otolaryngology, Loyola University Medical Center, Maywood, Illinois, USA., Ali S; Department of Otolaryngology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA., Blackwell KE; Department of Otolaryngology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA., Buchakjian M; Department of Otolaryngology, University of Iowa Health Care, Iowa City, Iowa, USA., Bur AM; Department of Otolaryngology, University of Kansas Medical Center, Kansas City, Kansas, USA., Cannady SB; Department of Otolaryngology, University of Pennsylvania Medicine, Philadelphia, Pennsylvania, USA., Castellanos CX; Caruso Department of Otolaryngology, University of Southern California, Los Angeles, California, USA., Ducic Y; Dallas/Fort Worth, Head & Neck Cancer Center of Texas, Texas, USA., Ghanem TA; Department of Otolaryngology, Henry Ford Health, Detroit, Michigan, USA., Huang AT; Department of Otolaryngology, Baylor College of Medicine, Houston, Texas, USA., Jackson RS; Department of Otolaryngology, Washington University School of Medicine, St. Louis, Missouri, USA., Kokot N; Caruso Department of Otolaryngology, University of Southern California, Los Angeles, California, USA., Li S; Department of Otolaryngology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA., Pipkorn P; Department of Otolaryngology, Washington University School of Medicine, St. Louis, Missouri, USA., Puram SV; Department of Otolaryngology, Washington University School of Medicine, St. Louis, Missouri, USA., Rezaee R; Department of Otolaryngology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA., Rajasekaran K; Department of Otolaryngology, University of Pennsylvania Medicine, Philadelphia, Pennsylvania, USA., Shnayder Y; Department of Otolaryngology, University of Kansas Medical Center, Kansas City, Kansas, USA., Sinha UK; Caruso Department of Otolaryngology, University of Southern California, Los Angeles, California, USA., Sukato D; Department of Otolaryngology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA., Suresh N; Department of Otolaryngology, University of Pennsylvania Medicine, Philadelphia, Pennsylvania, USA., Tamaki A; Department of Otolaryngology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA., Thomas CM; Department of Otolaryngology-Head & Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA., Thorpe EJ; Department of Otolaryngology, Loyola University Medical Center, Maywood, Illinois, USA., Wax MK; Department of Otolaryngology, Oregon Health & Science University, Portland, Oregon, USA., Yang S; Department of Otolaryngology, Oregon Health & Science University, Portland, Oregon, USA., Ziegler A; Department of Otolaryngology, Loyola University Medical Center, Maywood, Illinois, USA., Pittman AL; Department of Otolaryngology, Loyola University Medical Center, Maywood, Illinois, USA.
Jazyk: angličtina
Zdroj: The Laryngoscope [Laryngoscope] 2024 Nov; Vol. 134 (11), pp. 4521-4526. Date of Electronic Publication: 2023 Nov 08.
DOI: 10.1002/lary.31159
Abstrakt: Introduction: Coronavirus disease 2019 (COVID-19) affects the vascular system, subjecting patients to a hypercoagulable state. This is of particular concern for the success of microvascular free flap reconstruction. This study aims to report head and neck free flap complications in patients with COVID-19 during the perioperative period. We believe these patients are more likely to experience flap complications given the hypercoagulable state.
Methods: This is a multi-institutional retrospective case series of patients infected with COVID-19 during the perioperative period for head and neck free flap reconstruction from March 2020 to January 2022.
Results: Data was collected on 40 patients from 14 institutions. Twenty-one patients (52.5%) had a positive COVID-19 test within 10 days before surgery and 7 days after surgery. The remaining patients had a positive test earlier than 10 days before surgery. A positive test caused a delay in surgery for 16 patients (40.0%) with an average delay of 44.7 days (9-198 days). Two free flap complications (5.0%) occurred with no free flap deaths. Four patients (10.0%) had surgical complications and 10 patients had medical complications (25.0%). Five patients (12.5%) suffered from postoperative COVID-19 pneumonia. Three deaths were COVID-19-related and one from cancer recurrence during the study period.
Conclusion: Despite the heightened risk of coagulopathy in COVID-19 patients, head and neck free flap reconstructions in patients with COVID-19 are not at higher risk for free flap complications. However, these patients are at increased risk of medical complications.
Level of Evidence: 4 Laryngoscope, 134:4521-4526, 2024.
(© 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze: MEDLINE
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