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