Prospective evaluation of outcome measures in free-flap surgery.

Hdl Handle:
http://hdl.handle.net/10147/143781
Title:
Prospective evaluation of outcome measures in free-flap surgery.
Authors:
Kelly, John L; Eadie, Patricia A; Orr, David; Al-Rawi, Mogdad; O'Donnell, Margaret; Lawlor, Denis
Affiliation:
Department of Plastic Surgery, University College Hospital, Galway, Newcastle, Ireland.
Citation:
Prospective evaluation of outcome measures in free-flap surgery. 2004, 20 (6):435-8; discussion 439 J Reconstr Microsurg
Journal:
Journal of reconstructive microsurgery
Issue Date:
Aug-2004
URI:
http://hdl.handle.net/10147/143781
DOI:
10.1055/s-2004-833500
PubMed ID:
15356760
Additional Links:
https://www.thieme-connect.com/DOI/DOI?10.1055/s-2004-833500
Abstract:
Free-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary referral center. Anastomotic technique, ischemia time, choice of anticoagulant, and the grade of surgeon were recorded. The type of flap, medications, and co-morbidities, including preoperative radiotherapy, were also documented. Ten flaps were re-explored (17 percent). There were four cases of complete flap failure (6.7 percent) and five cases of partial failure (8.5 percent). In patients who received perioperative systemic heparin or dextran, there was no evidence of flap failure (p = .08). The mean ischemia time was similar in flaps that failed (95 +/- 29 min) and in those that survived (92 +/- 34 min). Also, the number of anastomoses performed by trainees in flaps that failed (22 percent), was similar to the number in flaps that survived (28 percent). Nine patients received preoperative radiotherapy, and there was complete flap survival in each case. This study reveals that closely supervised anastomoses performed by trainees may have a similar outcome to those performed by more senior surgeons. There was no adverse effect from radiotherapy or increased ischemia time on flap survival.
Item Type:
Article
Language:
en
Description:
Free-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary referral center. Anastomotic technique, ischemia time, choice of anticoagulant, and the grade of surgeon were recorded. The type of flap, medications, and co-morbidities, including preoperative radiotherapy, were also documented. Ten flaps were re-explored (17 percent). There were four cases of complete flap failure (6.7 percent) and five cases of partial failure (8.5 percent). In patients who received perioperative systemic heparin or dextran, there was no evidence of flap failure (p = .08). The mean ischemia time was similar in flaps that failed (95 +/- 29 min) and in those that survived (92 +/- 34 min). Also, the number of anastomoses performed by trainees in flaps that failed (22 percent), was similar to the number in flaps that survived (28 percent). Nine patients received preoperative radiotherapy, and there was complete flap survival in each case. This study reveals that closely supervised anastomoses performed by trainees may have a similar outcome to those performed by more senior surgeons. There was no adverse effect from radiotherapy or increased ischemia time on flap survival.
MeSH:
Analysis of Variance; Anastomosis, Surgical; Anticoagulants; Chi-Square Distribution; Clinical Competence; Female; Graft Survival; Humans; Ischemia; Male; Middle Aged; Prospective Studies; Reoperation; Surgical Flaps; Time Factors; Treatment Failure
ISSN:
0743-684X

Full metadata record

DC FieldValue Language
dc.contributor.authorKelly, John Len
dc.contributor.authorEadie, Patricia Aen
dc.contributor.authorOrr, Daviden
dc.contributor.authorAl-Rawi, Mogdaden
dc.contributor.authorO'Donnell, Margareten
dc.contributor.authorLawlor, Denisen
dc.date.accessioned2011-10-03T13:32:56Z-
dc.date.available2011-10-03T13:32:56Z-
dc.date.issued2004-08-
dc.identifier.citationProspective evaluation of outcome measures in free-flap surgery. 2004, 20 (6):435-8; discussion 439 J Reconstr Microsurgen
dc.identifier.issn0743-684X-
dc.identifier.pmid15356760-
dc.identifier.doi10.1055/s-2004-833500-
dc.identifier.urihttp://hdl.handle.net/10147/143781-
dc.descriptionFree-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary referral center. Anastomotic technique, ischemia time, choice of anticoagulant, and the grade of surgeon were recorded. The type of flap, medications, and co-morbidities, including preoperative radiotherapy, were also documented. Ten flaps were re-explored (17 percent). There were four cases of complete flap failure (6.7 percent) and five cases of partial failure (8.5 percent). In patients who received perioperative systemic heparin or dextran, there was no evidence of flap failure (p = .08). The mean ischemia time was similar in flaps that failed (95 +/- 29 min) and in those that survived (92 +/- 34 min). Also, the number of anastomoses performed by trainees in flaps that failed (22 percent), was similar to the number in flaps that survived (28 percent). Nine patients received preoperative radiotherapy, and there was complete flap survival in each case. This study reveals that closely supervised anastomoses performed by trainees may have a similar outcome to those performed by more senior surgeons. There was no adverse effect from radiotherapy or increased ischemia time on flap survival.en
dc.description.abstractFree-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary referral center. Anastomotic technique, ischemia time, choice of anticoagulant, and the grade of surgeon were recorded. The type of flap, medications, and co-morbidities, including preoperative radiotherapy, were also documented. Ten flaps were re-explored (17 percent). There were four cases of complete flap failure (6.7 percent) and five cases of partial failure (8.5 percent). In patients who received perioperative systemic heparin or dextran, there was no evidence of flap failure (p = .08). The mean ischemia time was similar in flaps that failed (95 +/- 29 min) and in those that survived (92 +/- 34 min). Also, the number of anastomoses performed by trainees in flaps that failed (22 percent), was similar to the number in flaps that survived (28 percent). Nine patients received preoperative radiotherapy, and there was complete flap survival in each case. This study reveals that closely supervised anastomoses performed by trainees may have a similar outcome to those performed by more senior surgeons. There was no adverse effect from radiotherapy or increased ischemia time on flap survival.-
dc.language.isoenen
dc.relation.urlhttps://www.thieme-connect.com/DOI/DOI?10.1055/s-2004-833500en
dc.subject.meshAnalysis of Variance-
dc.subject.meshAnastomosis, Surgical-
dc.subject.meshAnticoagulants-
dc.subject.meshChi-Square Distribution-
dc.subject.meshClinical Competence-
dc.subject.meshFemale-
dc.subject.meshGraft Survival-
dc.subject.meshHumans-
dc.subject.meshIschemia-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshProspective Studies-
dc.subject.meshReoperation-
dc.subject.meshSurgical Flaps-
dc.subject.meshTime Factors-
dc.subject.meshTreatment Failure-
dc.titleProspective evaluation of outcome measures in free-flap surgery.en
dc.typeArticleen
dc.contributor.departmentDepartment of Plastic Surgery, University College Hospital, Galway, Newcastle, Ireland.en
dc.identifier.journalJournal of reconstructive microsurgeryen
dc.description.provinceConnacht-

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