Effect of operative time on complications associated with free flap reconstruction of the head and neck. (16th November 2022)

• Record Type: Journal Article
• Authors: Irawati, Nina; Every, James; Dawson, Rebecca; Leinkram, David; Elliott, Michael; Ch'ng, Sydney; Low, Hubert; Palme, Carsten E.; Clark, Jonathan; Wykes, James
• Is Part Of: Clinical otolaryngology. Volume 48:Number 2(2023)
• Page Start: 175
• Page End: 181
• Publication Date: 2022-11-16
• Subjects: complication rate -- free flap -- head and neck surgery -- length of hospital stay -- microsurgery -- operative time; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1111/coa.14000
• Languages: English
• ISSNs: 1749-4478

Abstract

Abstract: 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.