Impact Of Preoperative And Intraoperative Management On Outcomes In Osteoradionecrosis Requiring Free Flap Reconstruction
Head and Neck
Background: Perioperative management of advanced osteoradionecrosis of the head and neck requiring free flap (FF) reconstruction varies. Our objectives included assessment of practice patterns and outcomes. Methods: Multi-institutional, retrospective review of FF reconstruction for head and neck osteoradionecrosis (n = 260). Results: Administration of preoperative antibiotics did not correlate with reduction in postoperative complications. Preoperative alcohol use correlated with higher rates of hardware exposure (p = 0.03) and 30-day readmission (p = 0.04). Patients with FF compromise had higher TSH (p = 0.04) and lower albumin levels (p = 0.005). Prealbumin levels were lower in patients who required neck washouts (p = 0.02) or a second FF (p = 0.03). TSH levels were higher in patients undergoing postoperative debridement (p = 0.03) or local flap procedures (p = 0.04). Conclusion: Malnutrition, hypothyroidism, and substance abuse correlated with a higher incidence of postoperative wound complications in patients undergoing FF reconstruction for advanced osteoradionecrosis. Preoperative antibiotics use did not correlate with a reduction in postoperative wound complications.
Mayland, Erica; Curry, Joseph M.; Wax, Mark K.; Thomas, Carissa M.; Swendseid, Brian P.; Kejner, Alexandra E.; Kain, Joshua J.; Cannady, Steven B.; Miles, Brett A.; DiLeo, Michael; McMullen, Caitlin; Tasche, Kendall; Ferrandino, Rocco M.; Sarwary, Juliana; Petrisor, Daniel; and Sweeny, Larissa, "Impact Of Preoperative And Intraoperative Management On Outcomes In Osteoradionecrosis Requiring Free Flap Reconstruction" (2021). School of Medicine Faculty Publications. 1321.