Analysis on influencing factors of concurrent free anterolateral femoral skin flap repair in radical operation for oral cancer / 局解手术学杂志

ABSTRACT

Objective To explore the curative effect of oral cancer radical surgery plus free anterolateral thigh flap repair and analyze the influence factors of skin flap necrosis.Methods The data of 98 patients who underwent oral cancer radical surgery with concurrent free anterolateral thigh flap repair in our hospital from January 2010 to June 2015 were retrospectively analyzed.The complete survival rate of skin flaps and incidence of complications in all patients were statistically analyzed.The age,diabetes,infection in implanted skin flap area,smoking and mental status,etc.of patients with survived or necrotic skin flaps were compared between patients with survival flaps and patients with flap necrosis,and multivariate Logistic regression analysis was performed.Results Among the 98 cases,86 cases of flaps survived completely and the survival rate was 87.8%.Fifteen cases with the skin flap necrosis,the incidence of complications was 15.3%,including 7 cases of surgi-cal site infection and 5 cases of skin flap necrosis with massive hemorrhage.The donor site incisions of all patients were primary healing and the patients were satisfied with the postoperative appearance.Among the patients with flap necrosis,the incidence rates of ≥60 years old,with diabetes,infection in flap implanted area,smoking and poor mental state (41.7%,41.7%,58.3%,75.0%,83.3%)were higher than those corresponding proportions in the patients with with survival flaps(P <0.05).Multivariate Logistic regression analysis showed that age,diabe-tes,infection in implanted skin flap area,smoking and poor mental status were the influencing factors for flap necrosis.Conclusion Oral cancer radical surgery with concurrent free anterolateral thigh flap repair has good curative effects.The age,combined with diabetes,smoking,infec-tion in flap implanted area and poor mental state are the risk factors for flap necrosis in patients with oral cancer after flap repair,which should be given intervention to improve the survival rate of skin flap in clinic.