ABSTRACT
<p><b>OBJECTIVE</b>To identify the factors that were predictive of outcome and to determine the effect of age on perioperative complications.</p><p><b>METHODS</b>Reviewed the records of 1 100 consecutive patients who underwent anterolateral thigh flap free flap transfers for oral and maxillofacial cancer surgery defects between February 2002 and March 2013. All patients were divided into two groups: A group (< 60 years old) and B group (≥ 60 years old). Postoperative complications were analyzed from all patients.</p><p><b>RESULTS</b>There were 781 cases in A group and 319 in B group. The overall success rate was 97.2% (1 100/1 132) [97.3% (781/803) in A group, 97.0% (319/329) in B group, P > 0.05]. The overall complication rate was 27.5% (302/1 100) [25.9% (202/781) in A group, 31.3% (100/319) in B group, P = 0.064]. Multivariate Cox regression analyses revealed that American Society of Anesthesiologists (ASA) status (P < 0.001), operation time (P = 0.021) and comorbidity (P = 0.002) were the independent factor for the complication of patients. However, age (P > 0.05) was not an independent factor for the complication of patients.</p><p><b>CONCLUSIONS</b>Oral and maxillofacial reconstruction using anterolateral thigh flap free flaps in elderly patients can achieve similar outcomes as in younger patients. Controlling operative time is very important in reducing post-operative complications and improving the results of surgery.</p>