PDF(Pubmed)
Abstract：
Free flap reconstruction for postoperative tissue defects in oral and maxillofacial tumors is a critical component of reconstructive surgery. Identifying risk factors for flap necrosis is essential for improving surgical outcomes and patient quality of life. A retrospective study was conducted on patients who underwent free flap reconstruction between January 2020 and December 2023. Patients were included if they had comprehensive medical records and at least a six-month follow-up. We excluded those with a history of flap necrosis, uncontrolled systemic diseases, non-adherence to postoperative care, or concurrent malignancy treatments. Data on demographics, comorbidities, flap characteristics, and operative details were collected and analyzed using univariate analysis and logistic regression tests. Univariate analysis did not find a significant correlation between flap necrosis and factors such as hyperlipidemia, lymph node metastasis, or flap type. However, diabetes mellitus, oral infections, and albumin levels below 35 g/L were significantly associated with flap necrosis. Multivariate logistic regression showed diabetes mellitus increased the odds of flap necrosis by approximately ninefold, and oral infection increased it by over tenfold. Diabetes mellitus, oral infection, and low albumin levels are significant risk factors for flap necrosis in free flap reconstruction after oral and maxillofacial surgery. Prompt identification and management of these factors are crucial to mitigate the risk of flap necrosis.
摘要：
口腔颌面部肿瘤术后组织缺损的游离皮瓣重建是重建手术的重要组成部分。确定皮瓣坏死的危险因素对于改善手术效果和患者生活质量至关重要。对2020年1月至2023年12月接受游离皮瓣重建的患者进行了回顾性研究。如果患者有全面的医疗记录和至少六个月的随访，则将其包括在内。我们排除了有皮瓣坏死史的人,不受控制的系统性疾病，不坚持术后护理，或同时进行恶性肿瘤治疗。人口统计数据，合并症,襟翼特性，收集手术细节,采用单因素分析和logistic回归检验进行分析.单因素分析未发现皮瓣坏死与高脂血症、淋巴结转移,或皮瓣类型。然而,糖尿病,口腔感染,白蛋白水平低于35g/L与皮瓣坏死显著相关。多因素logistic回归分析显示糖尿病使皮瓣坏死的几率增加了约九倍，口腔感染使其增加了十倍以上。糖尿病,口腔感染,在口腔颌面外科术后游离皮瓣重建中，低白蛋白水平是皮瓣坏死的重要危险因素。及时识别和管理这些因素对于减轻皮瓣坏死的风险至关重要。
