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Free Flaps for Skin and Soft Tissue Reconstruction in the Elderly Patient: Indication or Contraindication
Background: Increased lifespan and the improvement of medical treatment have given rise to research in reconstructive procedures in elderly patients. Higher postoperative complication rates, longer rehabilitation, and surgical difficulties remain a problem in the elderly. We asked whether a free fla...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9944069/ https://www.ncbi.nlm.nih.gov/pubmed/36810479 http://dx.doi.org/10.3390/medsci11010012 |
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author | Sorg, Heiko Sorg, Christian G. G. Tilkorn, Daniel J. Thönnes, Simon Karimo, Rees Hauser, Jörg |
author_facet | Sorg, Heiko Sorg, Christian G. G. Tilkorn, Daniel J. Thönnes, Simon Karimo, Rees Hauser, Jörg |
author_sort | Sorg, Heiko |
collection | PubMed |
description | Background: Increased lifespan and the improvement of medical treatment have given rise to research in reconstructive procedures in elderly patients. Higher postoperative complication rates, longer rehabilitation, and surgical difficulties remain a problem in the elderly. We asked whether a free flap in elderly patients is an indication or a contraindication and performed a retrospective, monocentric study. Methods: Patients were divided into two groups (YOUNG 0–59 years; OLD > 60 years). The endpoint was the survival of flaps and their dependence on patient- and surgery-specific parameters using multivariate analysis. Results: A total of 110 patients (OLD n = 59) underwent 129 flaps. The chance of flap loss increased as soon as two flaps were performed in one surgery. Anterior lateral thigh flaps had the highest chance for flap survival. Compared with the lower extremity, the head/neck/trunk group had a significantly increased chance of flap loss. There was a significant increase in the odds of flap loss in linear relation to the administration of erythrocyte concentrates. Conclusion: The results confirm that free flap surgery can be indicated as a safe method for the elderly. Perioperative parameters such as two flaps in one surgery and transfusion regimens must be considered as risk factors for flap loss. |
format | Online Article Text |
id | pubmed-9944069 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-99440692023-02-23 Free Flaps for Skin and Soft Tissue Reconstruction in the Elderly Patient: Indication or Contraindication Sorg, Heiko Sorg, Christian G. G. Tilkorn, Daniel J. Thönnes, Simon Karimo, Rees Hauser, Jörg Med Sci (Basel) Article Background: Increased lifespan and the improvement of medical treatment have given rise to research in reconstructive procedures in elderly patients. Higher postoperative complication rates, longer rehabilitation, and surgical difficulties remain a problem in the elderly. We asked whether a free flap in elderly patients is an indication or a contraindication and performed a retrospective, monocentric study. Methods: Patients were divided into two groups (YOUNG 0–59 years; OLD > 60 years). The endpoint was the survival of flaps and their dependence on patient- and surgery-specific parameters using multivariate analysis. Results: A total of 110 patients (OLD n = 59) underwent 129 flaps. The chance of flap loss increased as soon as two flaps were performed in one surgery. Anterior lateral thigh flaps had the highest chance for flap survival. Compared with the lower extremity, the head/neck/trunk group had a significantly increased chance of flap loss. There was a significant increase in the odds of flap loss in linear relation to the administration of erythrocyte concentrates. Conclusion: The results confirm that free flap surgery can be indicated as a safe method for the elderly. Perioperative parameters such as two flaps in one surgery and transfusion regimens must be considered as risk factors for flap loss. MDPI 2023-01-21 /pmc/articles/PMC9944069/ /pubmed/36810479 http://dx.doi.org/10.3390/medsci11010012 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Sorg, Heiko Sorg, Christian G. G. Tilkorn, Daniel J. Thönnes, Simon Karimo, Rees Hauser, Jörg Free Flaps for Skin and Soft Tissue Reconstruction in the Elderly Patient: Indication or Contraindication |
title | Free Flaps for Skin and Soft Tissue Reconstruction in the Elderly Patient: Indication or Contraindication |
title_full | Free Flaps for Skin and Soft Tissue Reconstruction in the Elderly Patient: Indication or Contraindication |
title_fullStr | Free Flaps for Skin and Soft Tissue Reconstruction in the Elderly Patient: Indication or Contraindication |
title_full_unstemmed | Free Flaps for Skin and Soft Tissue Reconstruction in the Elderly Patient: Indication or Contraindication |
title_short | Free Flaps for Skin and Soft Tissue Reconstruction in the Elderly Patient: Indication or Contraindication |
title_sort | free flaps for skin and soft tissue reconstruction in the elderly patient: indication or contraindication |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9944069/ https://www.ncbi.nlm.nih.gov/pubmed/36810479 http://dx.doi.org/10.3390/medsci11010012 |
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