Maxillofacial Microvascular Free-Flap Reconstructions in Pediatric and Young Adult Patients-Outcomes and Potential Factors Influencing Success Rate.
Dominika LechJeremi MatysekRobert MaksymowiczCyprian StrączekRobert MargułaŁukasz KrakowczykMarcin KozakiewiczKrzysztof DowgierdPublished in: Journal of clinical medicine (2024)
Background : Maxillofacial microvascular free-flap reconstructions are significant interventions in the management of congenital defects, traumatic injuries, malignancies, and iatrogenic complications in pediatric and young adult patients. Craniofacial disorders within this demographic can result in profound functional, cosmetic, and psychosocial impairments, highlighting the critical need for thorough investigation into factors that may influence procedural success and postoperative quality of life. This retrospective chart review aims to examine the outcomes and potential influencing factors, aiming to offer valuable insights into optimizing the effectiveness of these reconstructions and improving patient outcomes. Methods : A single head and neck surgical team performed all the included 136 procedures. Demographic and surgical patient data were recorded. Type of transfer performed in each recipient site and major complications were analyzed. Relevant influencing factors, such as age, gender, and etiology of defect were determined using the ANOVA test and χ 2 test of independence. Results : The results indicate a 90% success rate. No significant relationship was found between the incidence of total flap loss and patient age, etiology, or graft source. The maxillary reconstructions showed a higher incidence of total flap loss compared to mandibular reconstructions (11 vs. 3 cases). Conclusions : Despite the high success rate, the findings underline the necessity for further research to validate these observations and enhance surgical methods for pediatric and young adult patients.
Keyphrases
- image quality
- risk factors
- middle aged
- case report
- mental health
- randomized controlled trial
- systematic review
- physical activity
- patients undergoing
- palliative care
- computed tomography
- cross sectional
- type diabetes
- soft tissue
- breast reconstruction
- electronic health record
- intellectual disability
- big data
- magnetic resonance
- quality improvement
- adipose tissue
- machine learning
- childhood cancer