The establishment of a microvascular free flap service in a medium-sized hospital (500 beds)—an eight-year experience
| Autor: | Aviv Kramer, Ilana Doweck, Miriam Segal-Trabelsi, Arie Bitterman, Yaron Har-Shai, Leonid Bryzgalin, Nir Eyal, Eyal Franco, Idit Lavi, Aharon Amir, Issa Metanes |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Wound dehiscence business.industry medicine.medical_treatment Fistula Retrospective cohort study Free flap 030230 surgery Microsurgery medicine.disease Surgery 03 medical and health sciences Plastic surgery 0302 clinical medicine 030220 oncology & carcinogenesis Seroma medicine Fat necrosis business |
| Zdroj: | European Journal of Plastic Surgery. 43:37-42 |
| ISSN: | 1435-0130 0930-343X |
| Popis: | Microsurgery is a specialized procedure that necessitates well-trained and experienced surgeons and a skilled nursing care staff. This study presents our experience with a free flap service in a medium-sized hospital and its feasibility. This retrospective study included 91 patients who underwent breast and head and neck free tissue reconstruction between March 2010 and February 2018, by a single microsurgeon. Pre- and post-operative protocols were implemented. Data was retrospectively collected regarding age, gender, medical history, pre-oncological treatments, type of flaps, operation time, success, failure, re-exploration and salvage rates, minor and major complications, and hospitalization length. Mean operation time was 12.5 h (range 4–26.8 h). Average hospital stay was 14 days (breast 11 days, head and neck 17 days), range 7–56 days. The overall flap success rate was 89% (breast 92.2%, head and neck 85.4%). Total complication rate was 60.6%. Minor complications 41.4% (breast 22.2%, head and neck 19.2%) and major complications 19.2% (breast 8.1%, head and neck 11.1%). Minor complications included seroma (breast 5.9%, head and neck 4.2%), infection/abscess (breast 2%, head and neck 10.4%), wound dehiscence (breast 3.9%, head and neck 8.3%), fistula (breast 0%, head and neck 8.3%), and fat necrosis (breast 21.5%, head and neck 0%). Major complications included flap necrosis (breast 9.8%, head and neck 8.3%) and venous thrombosis (breast 7.8%, head and neck 8.3%). This study demonstrated the probability of a reconstructive microsurgical service in a medium-sized hospital which achieves respectable results that meet international standards. Level of evidence: Level IV, therapeutic study. |
| Databáze: | OpenAIRE |
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