ArticleJournal of reconstructive microsurgery2022
Postoperative Complications Associated with the Choice of Reconstruction in Head and Neck Cancer: An Outcome Analysis of 4,712 Patients from the ACS-NSQIP Database.
Article in Journal of reconstructive microsurgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Autologous Fat Grafting for Functional and Aesthetic Improvement in Patients with Head and Neck Cancer: A Systematic Review.Aesthetic plastic surgery · 2023Pooled it
- Free flap versus pedicled flap reconstruction in head and neck surgery: A systematic review and meta-analysis.JPRAS open · 2026Review
- The nürnberg approach: a decision model for local vs. microvascular reconstruction in oral cancer surgery.Clinical oral investigations · 2026Article
- Recovery Phenotypes After Head-and-Neck Reconstructive Surgery: A Prospective Cohort Comparing Free-Flap and Pedicled-Flap Pathways.Diseases (Basel, Switzerland) · 2026Article
- Challenging reconstruction of oncologic defects of the parotid region: a single-institution experience and decision-making framework proposal.Oral and maxillofacial surgery · 2026Article
- Complication drivers in head and neck free flap surgery: A single-center predictive analysis.Oral and maxillofacial surgery · 2026Article
- Free vs. Local Tissue Transfer and Reconstruction in Pediatric Head and Neck Cancer Patients: A Comparable Complication Outcome Review.Medicina (Kaunas, Lithuania) · 2025Article
- Comparison of short-term outcomes between pedicled- and free-flap autologous breast reconstruction: a nationwide inpatient database study in Japan.Breast cancer (Tokyo, Japan) · 2022Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundMicrosurgical free flaps have largely supplanted pedicled flaps as the gold standard for head and neck cancer reconstruction. However, incidence of postoperative complications after accounting for patient comorbidities based on choice of reconstruction has not been well-defined in the literature in recent years.
methodsPatients undergoing head and neck reconstruction were identified in the 2011-2016 ACS-NSQIP (American College of Surgeons National Surgical Quality Improvement Program) database and stratified into groups by free flap, myocutaneous pedicled flap, and other reconstruction. Demographics were analyzed and covariates balanced using overlap propensity score-based weighting. Logistic regression was used for binary outcomes and Gamma generalized linear model was used for length of stay.
resultsA total of 4,712 patients met inclusion criteria out of which 1,297 patients (28%) underwent free flap, 208 patients (4%) pedicled flap, and 3,207 patients (68%) had other, or no reconstruction performed. After adjusting for patient and disease-specific factors, pedicled flap reconstruction was associated with a higher risk of deep vein thrombosis (odds ratio [OR] = 2.64, confidence interval [CI] 1.02-6.85,
conclusionMyocutaneous pedicled flaps are associated with higher overall short-term postoperative complications compared with free flaps in head and neck reconstruction, which demonstrate a more favorable morbidity profile without significantly impacting hospital readmission, reoperation, or length-of-stay.
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