Abstract：
(1) Background: Postoperative flap loss and wound healing disorders are severe complications after microsurgical free flap surgery. Despite multiple clinical observations, a possible influence of season and external temperature on outcome are largely missing. (2) Methods: Retrospectively, data were collected from 151 patients receiving microsurgical free flaps from March 2018 to August 2019. Patients were divided into two cohorts. The winter group includes all patients who underwent surgery from October 2018 to March 2019 and the summer group al those who underwent surgery from April 2018 to September 2018. Data included demographic information, pre-existing conditions, flap characteristics, and postoperative complications like flap losses and wound healing problems. External temperatures during the first 14 postoperative days were documented and the predictor of flap loss and wound healing disorders was detected. (3) Results: In the winter group (October-March; Ø 7.24 °C) 72 patients (46 female, 24 males; Ø 57.0 years) and in the summer group (April-September; Ø 18.79 °C) 81 patients (48 female, 33 males; Ø 56.0 years) received free flap surgery. There were no significant differences in demography (age: p = 0.593; gender: p = 0.419; BMI: p = 0.141). We found a significant increase in flap loss during summer (χ2(1) = 6.626; p = 0.010; V = 0.209) strengthened by logistic regression analysis (p = 0.037; Exp(B) = 9.655). Additionally higher average temperatures 14 days postoperatively represents another main driver (p = 0.023, Exp(B) = 1.161) for postoperative flap loss. (4) Conclusions: The data confirm a significantly higher postoperative flap loss in the summer group. This information may potentially contribute to optimization of perioperative management and planning of elective and semi-elective surgeries.
摘要：
(1)背景:术后皮瓣丢失和伤口愈合障碍是显微游离皮瓣手术后的严重并发症。尽管有多项临床观察,季节和外部温度对结果的可能影响在很大程度上缺失。(2)方法:回顾性研究,数据来自2018年3月至2019年8月接受显微手术游离皮瓣的151例患者.将患者分为两组。冬季组包括2018年10月至2019年3月接受手术的所有患者，夏季组包括2018年4月至2018年9月接受手术的患者。数据包括人口统计信息，预先存在的条件，襟翼特性，以及术后并发症，如皮瓣丢失和伤口愈合问题。记录术后前14天的外部温度，并检测皮瓣丢失和伤口愈合障碍的预测因子。（3）结果：冬季组（10月至3月；Ø7.24°C）72例患者（46例女性，24名男性；Ø57.0岁），夏季组（4月至9月；Ø18.79°C）81名患者（48名女性，33例男性；Ø56.0岁）接受游离皮瓣手术。人口统计学差异无统计学意义（年龄：p=0.593；性别：p=0.419；BMI：p=0.141）。通过逻辑回归分析（p=0.037；Exp（B）=9.655），我们发现夏季皮瓣损失显着增加（χ2（1）=6.626；p=0.010；V=0.209）。此外，术后14天更高的平均温度代表了术后皮瓣丢失的另一个主要驱动因素（p=0.023，Exp（B）=1.161）。（4）结论：数据证实夏季组术后皮瓣丢失明显较高。这些信息可能有助于优化围手术期管理以及选择性和半选择性手术的计划。
