PREDICTION OF OUTCOMES IN 150 PATIENTS HAVING MICROVASCULAR FREE TISSUE TRANSFERS TO THE HEAD AND NECK

Medical records of 150 patients who had undergone microvascular free t issue transfer to the head and neck (85% for malignancy) were retrospe ctively assessed to identify predictors of postoperative outcomes and complications. 5% of flaps failed and 20% required re-exploration. Sur gical and medical problems occurred in 23% and 67% patients respective ly; mortality was 4.7%. 132 records were analysed by logistic regressi on. Mortality and stroke were commoner in patients with previous myoca rdial infarction or steroid medication. Chest infection was commoner i n men and with increasing age. Hypoxaemia was associated with bronchod ilator therapy. Thromboembolism was commoner in patients on diuretics. Nutritional problems were more frequent in patients on opioids, with low weight or hypertension. Donor site infection was related to haemog lobin concentration, cerebrovascular disease, hypertension, opioid con sumption or previous radiotherapy. Recipient site infection was associ ated with hypertension. Flap failure was related to nitrate or broncho dilator treatment. Re-exploration was associated with opioid or bronch odilator therapy. It was concluded that several factors predicted comp lications and death following microvascular surgery to the head and ne ck.