Abstract
Our main objective was to apply a standard classification to surgical complications
after free flap surgery for reconstructions of the head and neck. We used the modified
Clavien–Dindo classification in a cohort of 79 patients who were having reconstructions
with jejunal free flaps simultaneously with resections of oral and oropharyngeal cancer.
The most common minor complication was the need for a blood transfusion, and the most
common major complication of a respiratory nature. The medical complications, and
those at the recipient site and the donor site were 53/79 (67%), 44/79 (56%), and
9/79 (11%), respectively. The Clavien–Dindo classification is suitable and can easily
be used to evaluate postoperative complications after free tissue transfer.
Keywords
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References
- Accountability measures—using measurement to promote quality improvement.N Engl J Med. 2010; 363: 683-688
- Quality of complication reporting in the surgical literature.Ann Surg. 2002; 235: 803-813
- Analytic review of 2372 free flap transfers for head and neck reconstruction following cancer resection.J Reconstr Microsurg. 2003; 19: 363-368
- Microsurgical reconstruction in the head and neck region: an 18-year experience with 500 consecutive cases.J Craniomaxillofac Surg. 2003; 31: 197-201
- Free tissue transfer reconstruction of the head and neck at a Veterans Affairs hospital.Head Neck. 2008; 30: 1007-1011
- Factors associated with complications in microvascular reconstruction of head and neck defects.Plast Reconstr Surg. 1999; 103: 403-411
- Analysis of outcome and complications in 400 cases of microvascular head and neck reconstruction.Arch Otolaryngol Head Neck Surg. 2004; 130: 962-966
- Complications and functional outcomes following complex oropharyngeal reconstruction.Head Neck. 2010; 32: 1003-1011
- Postoperative medical complications—not microsurgical complications—negatively influence the morbidity, mortality, and true costs after microsurgical reconstruction for head and neck cancer.Plast Reconstr Surg. 2007; 119: 2053-2060
- Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey.Ann Surg. 2004; 240: 205-213
- The Clavien–Dindo classification of surgical complications: five-year experience.Ann Surg. 2009; 250: 187-196
- Primary chemotherapy in resectable oral cavity squamous cell cancer: a randomized controlled trial.J Clin Oncol. 2003; 21: 327-333
- Experience with microvascular free flaps in preoperatively irradiated tissue of the oral cavity and oropharynx in 303 patients.Oral Oncol. 2005; 41: 738-746
- Preoperative chemoradiotherapy in the management of oral cancer: a review.J Craniomaxillofac Surg. 2008; 36: 75-88
- Free jejunal graft autotransplantation should be revascularized within 3 hours.Transplant Proc. 1998; 30: 3446-3448
- A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.J Chronic Dis. 1987; 40: 373-383
- What is a surgical complication?.World J Surg. 2008; 32: 939-941
- Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee.Am J Infect Control. 1999; 27: 97-132
- Free flap reconstruction of the head and neck: analysis of 241 cases.Otolaryngol Head Neck Surg. 2001; 125: 10-17
- Multivariable predictors of postoperative respiratory failure after general and vascular surgery: results from the patient safety in surgery study.J Am Coll Surg. 2007; 204: 1188-1198
- Periodic alterations of jejunal mucosa morphology following free microvascular transfer for pharyngoesophageal reconstruction.J Plast Reconstr Aesthet Surg. 2006; 59: 1312-1317
- Incidence and time of intraoperative vascular complications in head and neck microsurgery.Microsurgery. 2008; 28: 143-146
- Study of the length of hospital stay for free flap reconstruction of oral and pharyngeal cancer in the context of the new French casemix-based funding.Oral Oncol. 2010; 46: 190-194
- Risk factors for postoperative complications in oral cancer and their prognostic implications.Arch Otolaryngol Head Neck Surg. 2001; 127: 828-833
- Perioperative complications, comorbidities, and survival in oral or oropharyngeal cancer.Arch Otolaryngol Head Neck Surg. 2003; 129: 219-228
Article info
Publication history
Published online: February 24, 2011
Accepted:
January 25,
2011
Identification
Copyright
© 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
