Evidence map›Paper›PMID 40657946›Full record

ArticleMicrosurgery2025

Impact of Vasopressors on Microvascular Free Flap Perfusion in Head and Neck Reconstruction.

Mark Ooms, Philipp Winnand, Marius Heitzer, Nils Vohl, Marie Katz, Johannes Bickenbach, Frank Hölzle, Ali Modabber

Abstract read
In one paragraph

Article in Microsurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
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.

Mark OomsDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.ORCID https://orcid.org/0000-0002-9785-9502
Philipp WinnandDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.
Marius HeitzerDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.ORCID https://orcid.org/0000-0002-9205-6065
Nils VohlDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.
Marie KatzDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.
Johannes BickenbachDepartment of Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany.
Frank HölzleDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.
Ali ModabberDepartment of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe use of vasopressors in microvascular head and neck reconstruction is still controversial in view of its potentially negative influence on microvascular flap perfusion, which is crucial for flap viability and commonly used as a parameter in flap monitoring. The aim of this study was to investigate the influence of vasopressors on microvascular free flap perfusion. MATERIALS AND

methodsPerfusion measurement data recorded intraoperatively and postoperatively using the Oxygen-2-see (O2C) analysis system in 274 patients undergoing microvascular head and neck reconstruction with fasciocutaneous free flaps (FFFs) or perforator free flaps (PFFs) between 2011 and 2020 were analyzed retrospectively. Vasopressor dose and perfusion parameters, such as flap blood flow, hemoglobin concentration, and hemoglobin oxygen saturation, as well as flap flow conductance (calculated as the ratio of flap blood flow and mean arterial blood pressure), were tested for associations.

resultsIntraoperative hemoglobin oxygen saturation and postoperative flap blood flow were negatively associated with vasopressor dose in PFFs (r = -0.307, p < 0.001; r = -0.211, p = 0.012, respectively). Both associations remained in multivariable analysis (p = 0.002; p = 0.022, respectively). Postoperative flap flow conductance was negatively associated with vasopressor dose in PFFs (r = -0.232, p = 0.008). This association remained in multivariable analysis (p = 0.023).

conclusionThe use of vasopressors influences microvascular free flap perfusion in PFFs in terms of intraoperative hemoglobin oxygen saturation, postoperative flap blood flow, and postoperative flap flow conductance. This suggests that the use of vasopressors in PFFs may be an adjustable variable for controlling flap perfusion and should be considered a confounding variable during flap monitoring based on flap perfusion.

Indexed as

Free Tissue FlapsHead and Neck NeoplasmsPlastic Surgery ProceduresVasoconstrictor AgentsAdultAgedFemaleGraft SurvivalHumansMaleMicrosurgeryMiddle AgedRegional Blood FlowRetrospective StudiesVasoconstrictor Agentsflap perfusionfree flaphead and neck reconstructionmicrosurgeryvasopressors

Identifiers

PMID40657946
PMCPMC12257995

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.