Evidence map›Paper›PMID 40100431›Full record

ArticleClinical oral investigations2025

Microvascular free flaps in head and neck reconstruction: an analysis of outcomes in elderly patients.

Jakob Fenske, Philipp Lampert, Claudius Steffen, Henri Kreiker, Steffen Koerdt, Kilian Kreutzer, Max Heiland, Carsten Rendenbach

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical oral investigations, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jakob FenskeDepartment of Oral and Maxillofacial Surgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. jakob.fenske@charite.de.
Philipp LampertDepartment of Oral and Maxillofacial Surgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Claudius SteffenDepartment of Oral and Maxillofacial Surgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Henri KreikerDepartment of Oral and Maxillofacial Surgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Steffen KoerdtDepartment of Oral and Maxillofacial Surgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Kilian KreutzerDepartment of Oral and Maxillofacial Surgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Max HeilandDepartment of Oral and Maxillofacial Surgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Carsten RendenbachDepartment of Oral and Maxillofacial Surgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesMaxillofacial reconstruction using microvascular free flaps is a well-established procedure to restore facial defects across various patients. Elderly patients face increased perioperative risks due to higher prevalence of comorbidities. This study aims to evaluate the characteristics of patients aged ≥ 75 years and assess the impact of advanced age on outcomes in microvascular free flap reconstruction for head and neck defects.

methodsA retrospective analysis was conducted on patients who underwent microvascular free flap head and neck reconstruction between April 2017 and July 2023. After matching, patients aged ≥ 75 were compared to those < 75 years regarding comorbidities, surgical and treatment variables, complication rates and outcomes. Multivariate models were developed to test the influence of age on flap complications.

results1050 patients met the inclusion criteria. 290 patients (28%) were ≥ 75 years old. Following case matching, 580 patients (276 females, mean age 74.1 ± 8.9 years) were included in the analysis. Patients ≥ 75 years had higher rates of comorbidities, co-medications and postoperative delirium. No significant differences were observed in flap complications between both groups in univariate analysis. Although one multivariate model suggested a potential non-linear effect of age on flap complications, this was not validated in another model.

conclusionsDespite the increased prevalence of comorbidities and perioperative risk factors, microvascular free flap reconstruction remains a safe and viable procedure for elderly patients when performed in a structured setting at a high-volume center, as complication rates do not appear to be directly influenced by age. CLINICAL RELEVANCE: Free Flap surgery is a safe procedure in elderly patients.

Indexed as

Age FactorsFree Tissue FlapsHead and Neck NeoplasmsOral Surgical ProceduresPlastic Surgery ProceduresPostoperative ComplicationsAgedAged, 80 and overComorbidityFemaleFollow-Up StudiesHumansJaw DiseasesMaleMatched-Pair AnalysisMicrovesselsComplicationsDeliriumElderlyFree flap surgeryMaxillofacial reconstructionMicrovascular free flap

Identifiers

PMID40100431
PMCPMC11919923

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.