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Thirty-Day Outcomes following Upper Extremity Flap Reconstruction

Introduction  Flap reconstructions of upper extremity defects are challenging procedures. It is important to understand the surgical outcomes of upper extremity flap reconstruction, as well as associations between preoperative/perioperative variables and complications. Materials and Methods  The Nat...

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Autores principales: Wright, Thomas, Donato, Daniel, Veith, Jacob, Magno-Padron, David, Agarwal, Jayant
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical and Scientific Publishers Private Ltd. 2021
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8041497/
https://www.ncbi.nlm.nih.gov/pubmed/33867769
http://dx.doi.org/10.1055/s-0040-1715557
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author Wright, Thomas
Donato, Daniel
Veith, Jacob
Magno-Padron, David
Agarwal, Jayant
author_facet Wright, Thomas
Donato, Daniel
Veith, Jacob
Magno-Padron, David
Agarwal, Jayant
author_sort Wright, Thomas
collection PubMed
description Introduction  Flap reconstructions of upper extremity defects are challenging procedures. It is important to understand the surgical outcomes of upper extremity flap reconstruction, as well as associations between preoperative/perioperative variables and complications. Materials and Methods  The National Surgical Quality Improvement Program (NSQIP) database was queried for patients from 2005 to 2016 who underwent flap reconstruction of an upper extremity defect. Patient and perioperative variables were collected for identified patients and assessed for associations with rates of any complication and major complications. Results  On multivariate analysis, American Society of Anesthesiologists (ASA) classification >2, bleeding disorder, preoperative steroid use, free flap reconstruction, wound classification other than clean, and nonplastic surgeon specialty were independently associated with any complications. Bleeding disorder, ASA classification >2, male gender, wound classification other than clean, and preoperative anemia were independently associated with major complications. Free flap reconstruction was associated with increased length of stay, operative time, any complications, transfusions, and unplanned reoperations. Conclusion  There is an association between complications in patients undergoing upper extremity free flap reconstruction and ASA classification >2, preoperative anemia, preoperative steroid use, bleeding disorders, and contaminated wounds. Male patients may require more thorough counseling in activity restriction following reconstruction. Free flaps for upper extremity reconstruction will require increased planning to reduce the chance of complications.
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spelling pubmed-80414972021-08-17 Thirty-Day Outcomes following Upper Extremity Flap Reconstruction Wright, Thomas Donato, Daniel Veith, Jacob Magno-Padron, David Agarwal, Jayant J Hand Microsurg Introduction  Flap reconstructions of upper extremity defects are challenging procedures. It is important to understand the surgical outcomes of upper extremity flap reconstruction, as well as associations between preoperative/perioperative variables and complications. Materials and Methods  The National Surgical Quality Improvement Program (NSQIP) database was queried for patients from 2005 to 2016 who underwent flap reconstruction of an upper extremity defect. Patient and perioperative variables were collected for identified patients and assessed for associations with rates of any complication and major complications. Results  On multivariate analysis, American Society of Anesthesiologists (ASA) classification >2, bleeding disorder, preoperative steroid use, free flap reconstruction, wound classification other than clean, and nonplastic surgeon specialty were independently associated with any complications. Bleeding disorder, ASA classification >2, male gender, wound classification other than clean, and preoperative anemia were independently associated with major complications. Free flap reconstruction was associated with increased length of stay, operative time, any complications, transfusions, and unplanned reoperations. Conclusion  There is an association between complications in patients undergoing upper extremity free flap reconstruction and ASA classification >2, preoperative anemia, preoperative steroid use, bleeding disorders, and contaminated wounds. Male patients may require more thorough counseling in activity restriction following reconstruction. Free flaps for upper extremity reconstruction will require increased planning to reduce the chance of complications. Thieme Medical and Scientific Publishers Private Ltd. 2021-04 2020-09-17 /pmc/articles/PMC8041497/ /pubmed/33867769 http://dx.doi.org/10.1055/s-0040-1715557 Text en Society of Indian Hand & Microsurgeons. All rights reserved. Thieme Medical and Scientific Publishers Pvt. Ltd., A-12, 2nd Floor, Sector 2, Noida-201301 UP, India https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Wright, Thomas
Donato, Daniel
Veith, Jacob
Magno-Padron, David
Agarwal, Jayant
Thirty-Day Outcomes following Upper Extremity Flap Reconstruction
title Thirty-Day Outcomes following Upper Extremity Flap Reconstruction
title_full Thirty-Day Outcomes following Upper Extremity Flap Reconstruction
title_fullStr Thirty-Day Outcomes following Upper Extremity Flap Reconstruction
title_full_unstemmed Thirty-Day Outcomes following Upper Extremity Flap Reconstruction
title_short Thirty-Day Outcomes following Upper Extremity Flap Reconstruction
title_sort thirty-day outcomes following upper extremity flap reconstruction
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8041497/
https://www.ncbi.nlm.nih.gov/pubmed/33867769
http://dx.doi.org/10.1055/s-0040-1715557
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