Effect of operative time on complications associated with free flap reconstruction of the head and neck

Objective To evaluate whether prolonged operative time is negatively associated with post‐operative complications and length of stay in patients undergoing microvascular free flap reconstruction for complex head and neck defects. Methods 342 consecutive patients undergoing microvascular reconstructi...

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Published in:Clinical otolaryngology 2023-03, Vol.48 (2), p.175-181
Main Authors: Irawati, Nina, Every, James, Dawson, Rebecca, Leinkram, David, Elliott, Michael, Ch'ng, Sydney, Low, Hubert, Palme, Carsten E., Clark, Jonathan, Wykes, James
Format: Article
Language:English
Subjects:
complication rate
Complications
Defects
free flap
Free Tissue Flaps - blood supply
Head and neck
Head and Neck Neoplasms - surgery
head and neck surgery
Humans
length of hospital stay
Length of Stay
microsurgery
Microvasculature
Operative Time
Patients
Plastic surgery
Plastic Surgery Procedures - adverse effects
Postoperative Complications - epidemiology
Reconstructive surgery
Retrospective Studies
Treatment Outcome
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Summary:Objective To evaluate whether prolonged operative time is negatively associated with post‐operative complications and length of stay in patients undergoing microvascular free flap reconstruction for complex head and neck defects. Methods 342 consecutive patients undergoing microvascular reconstruction for head and neck defects between 2017–2019 at a single institution were evaluated. Operative outcomes and operative time were compared whilst controlling for patient and treatment related factors. Results Mean operative time was 551 min and length of stay was 16.2 days. An 11% increase in the risk of a post‐operative complication was observed for every additional hour of operative time (OR 1.11, 95% CI 1.03–1.21, p = 0.011) after adjusting for patient and treatment factors. A cut‐off of 9 h yielded a 92% increase in complications on either side of this (OR 1.92, 95% CI 1.18–3.13, p = 0.009). Increased operative time was also associated with increased length of stay and return to theatres, but not medical complications. Conclusion Prolonged operative time is significantly associated with increased surgical complications, length of stay and return to theatres when performing microvascular reconstructive surgery for head and neck defects.
ISSN:1749-4478
1749-4486
DOI:10.1111/coa.14000