{Reference Type}: Journal Article
{Title}: Consensus of free flap complications: Using a nomenclature paradigm in microvascular head and neck reconstruction.
{Author}: Mady LJ;Poonia SK;Baddour K;Snyder V;Kurukulasuriya C;Frost AS;Cannady SB;Chinn SB;Fancy T;Futran N;Hanasono MM;Lewis CM;Miles BA;Patel U;Richmon JD;Wax MK;Yu P;Solari MG;Sridharan S;
{Journal}: Head Neck
{Volume}: 43
{Issue}: 10
{Year}: 10 2021
{Factor}: 3.821
{DOI}: 10.1002/hed.26789
{Abstract}: 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.