%0 Journal Article
%T Consensus of free flap complications: Using a nomenclature paradigm in microvascular head and neck reconstruction.
%A Mady LJ
%A Poonia SK
%A Baddour K
%A Snyder V
%A Kurukulasuriya C
%A Frost AS
%A Cannady SB
%A Chinn SB
%A Fancy T
%A Futran N
%A Hanasono MM
%A Lewis CM
%A Miles BA
%A Patel U
%A Richmon JD
%A Wax MK
%A Yu P
%A Solari MG
%A Sridharan S
%J Head Neck
%V 43
%N 10
%D 10 2021
%M 34145676
%F 3.821
%R 10.1002/hed.26789
%X We aim to define a set of terms for common free flap complications with evidence-based descriptions.
Clinical consensus surveys were conducted among a panel of head and neck/reconstructive surgeons (N = 11). A content validity index for relevancy and clarity for each item was computed and adjusted for chance agreement (modified kappa, K). Items with K < 0.74 for relevancy (i.e., ratings of "good" or "fair") were eliminated.
Five out of nineteen terms scored K < 0.74. Eliminated terms included "vascular compromise"; "cellulitis"; "surgical site abscess"; "malocclusion"; and "non- or mal-union." Terms that achieved consensus were "total/partial free flap failure"; "free flap takeback"; "arterial thrombosis"; "venous thrombosis"; "revision of microvascular anastomosis"; "fistula"; "wound dehiscence"; "hematoma"; "seroma"; "partial skin graft failure"; "total skin graft failure"; "exposed hardware or bone"; and "hardware failure."
Standardized reporting would encourage multi-institutional research collaboration, larger scale quality improvement initiatives, the ability to set risk-adjusted benchmarks, and enhance education and communication.