Risk factors of free flap necrosis: Multivariate Logistic regression analysis / 中华显微外科杂志

ABSTRACT

Objective To explore the related factors with skin flap necrosis,we concluded the cases of patients with skin defects after free flap plantation.Methods From 2001 to 2016,188 cases about 20 influencing factors were analyzed (The characteristics of patientsage,sex,smoke,diabetes,high blood pressure;Preoperative factorsinjured sections,injured causes,preoperative wound infection,preoperative wound osteomyelitis,the time from injury to operation;Intraoperative factorsoperator,operation time,anesthesia time,intraoperative rehydration fluids,the way of vascular anastomosis,the number of venous anastomosis,the area of flap;Postoperative factorsflap hematoma,flap infection,vascular crisis) and multivariate logistic regression analysis was used to analyze the relationship between these risk factors and flap necrosis.Results All 188 cases were treated with free anterolateral thigh flap to repair soft tissue defect and it was revealed that the 174 cases were successful (92.55％) and 23 cases were occured vascular crisis (12.23％),8 cases were arterial crisis,11 cases were vein crisis,4 cases were ateriovenous crisis.After the treatment,the rescue was successful in 5 cases (38.46％).After the analysis we made the conclusion that the number of venous anastomoses,flap hematoma and vascular crisis were related with the skin flap necrosis.Conclusion The number of venous anastomose (≥2) will increase blood return to make the flap easier to survive.Intraoperative stanching and drainage tube placement work will reduce the skin flap hematoma as a result of reducing the skin flap necrosis.Artery and venous crisis handled in time,can enhance the survival rate of flap.