TY - JOUR
T1 - A Multi-institutional Analysis of Late Complications in Scapula, Fibula, and Osteocutaneous Radial Forearm Free Flaps
AU - Bollig, Craig A.
AU - Walia, Amit
AU - Pipkorn, Patrik J.
AU - Jackson, Ryan S.
AU - Puram, Sidharth V.
AU - Rich, Jason T.
AU - Paniello, Randy C.
AU - Zevallos, Jose P.
AU - Stevens, Madelyn N.
AU - Wood, C. Burton
AU - Rohde, Sarah L.
AU - Sykes, Kevin
AU - Kakarala, Kiran
AU - Bur, Andres
AU - Wieser, Margaret E.
AU - Galloway, Tabitha L.I.
AU - Tassone, Patrick
AU - Sadeghi, Jairan
AU - Mattingly, Tyler R.
AU - Pluchino, Tyler
AU - Jorgensen, Jeffrey B.
N1 - Publisher Copyright:
© 2022 American Academy of Otolaryngology–Head and Neck Surgery Foundation.
PY - 2023/4
Y1 - 2023/4
N2 - Objectives: (1) Evaluate the association of flap type with late complications in patients undergoing osseous head and neck reconstruction with the fibula free flap (FFF), osteocutaneous radial forearm free flap (OCRFFF), and scapula free flap (SFF). (2) Compare the prevalence of late complications based on minimum duration of follow-up. Study Design: Retrospective cohort study. Setting: Multiple academic medical centers. Methods: Patients undergoing FFF, OCRFFF, or SFF with ≥6-month follow-up were stratified by type of flap performed. The association of flap type with late complications was analyzed via univariable and multivariable logistic regression, controlling for relevant clinical risk factors. Additionally, the frequency of late complications by minimum duration of follow-up was assessed. Results: A total of 617 patients were analyzed: 312 (50.6%) FFF, 230 (37.3%) OCRFFFF, and 75 (12.2%) SFF. As compared with the SFF, the FFF (adjusted odds ratio [aOR], 3.05; 95% CI, 1.61-5.80) and OCRFFF (aOR, 2.17; 95% CI, 1.12-4.22) were independently associated with greater odds of overall late recipient site wound complications. The SFF was independently associated with the lowest odds of hardware exposure when compared with the FFF (aOR, 2.61; 95% CI, 1.27-5.41) and OCRFFF (aOR, 2.38; 95% CI, 1.11-5.12). The frequency of late complications rose as minimum duration of follow-up increased until plateauing at 36 months. Conclusions: This multi-institutional study suggests that the long-term complication profile of the SFF and OCRFFF compares favorably to the FFF. The SFF may be associated with the fewest overall late recipient site complications and hardware exposure, while the FFF may be associated with the most of these 3 options.
AB - Objectives: (1) Evaluate the association of flap type with late complications in patients undergoing osseous head and neck reconstruction with the fibula free flap (FFF), osteocutaneous radial forearm free flap (OCRFFF), and scapula free flap (SFF). (2) Compare the prevalence of late complications based on minimum duration of follow-up. Study Design: Retrospective cohort study. Setting: Multiple academic medical centers. Methods: Patients undergoing FFF, OCRFFF, or SFF with ≥6-month follow-up were stratified by type of flap performed. The association of flap type with late complications was analyzed via univariable and multivariable logistic regression, controlling for relevant clinical risk factors. Additionally, the frequency of late complications by minimum duration of follow-up was assessed. Results: A total of 617 patients were analyzed: 312 (50.6%) FFF, 230 (37.3%) OCRFFFF, and 75 (12.2%) SFF. As compared with the SFF, the FFF (adjusted odds ratio [aOR], 3.05; 95% CI, 1.61-5.80) and OCRFFF (aOR, 2.17; 95% CI, 1.12-4.22) were independently associated with greater odds of overall late recipient site wound complications. The SFF was independently associated with the lowest odds of hardware exposure when compared with the FFF (aOR, 2.61; 95% CI, 1.27-5.41) and OCRFFF (aOR, 2.38; 95% CI, 1.11-5.12). The frequency of late complications rose as minimum duration of follow-up increased until plateauing at 36 months. Conclusions: This multi-institutional study suggests that the long-term complication profile of the SFF and OCRFFF compares favorably to the FFF. The SFF may be associated with the fewest overall late recipient site complications and hardware exposure, while the FFF may be associated with the most of these 3 options.
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U2 - 10.1177/01945998221116061
DO - 10.1177/01945998221116061
M3 - Article
C2 - 35917171
AN - SCOPUS:85135490980
SN - 0194-5998
VL - 168
SP - 681
EP - 687
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 4
ER -