Evidence map›Paper›PMID 40862499›Full record

ArticleJournal of surgical oncology2025

Preventing Free Flap Complications: Key Factors to Keep in Mind.

Jonas Kornmann, Rasmus Schug, Lena Huber, Anne Lammert, Frederic Jungbauer, Annette Affolter, Nicole Rotter, Lena Zaubitzer, Luis Bugia, Grietje Beck and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

11 authors.

Jonas KornmannDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.ORCID https://orcid.org/0009-0009-1346-0480
Rasmus SchugDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Lena HuberDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Anne LammertDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Frederic JungbauerDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Annette AffolterDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Nicole RotterDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Lena ZaubitzerDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Luis BugiaDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Grietje BeckDepartment of Anaesthesiology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Claudia ScherlDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.ORCID https://orcid.org/0000-0002-9651-0974

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesReconstruction of head and neck defects using free flaps is successful, but complications occur. This study aims to identify factors preventing complications to support clinical decision-making.

methodsRetrospective study for free flap reconstructions (2019 to 2022, tertiary referral center). Univariate and multivariate regression models assessed predictors of complication-free survival (CFS) and odds ratios (OR) measured risk correlations.

resultsOf 125 identified cases, most patients were male (71.8%) with a median age of 66 years (37-93 years). Common complications were wound healing disorders (10.9%), hematoma (10%), total (7.3%) or partial (1.8%) flap necrosis, cardiovascular events (5.5%), and pulmonary artery embolism (4.5%). 30-day CFS was 63%. On multivariable analysis, female gender (HR: 9.4, CI: 2.6-33.5), alcohol abuse (HR: 3.5, CI: 1.4-8.4), N2-3 (HR: 2.4, CI: 1.3-4.4), obesity (HR: 2.1, CI: 0.9-5.1), preoperative anticoagulation (HR: 2.5, CI: 1.1-5.9) were significant prognosticators. Positive factors increasing CFS included high albumin (OR 0.21, p = 0.02), intraoperative i.v. heparin bolus (OR 0.15, p = 0.08), intraoperative catecholamine treatment (OR 0.15, p = 0.009), and nonsmoking (OR 0.18, p = 0.1).

conclusionKey preventive measures against complications include optimizing nutritional status and albumin levels, administering intraoperative heparin and catecholamines, and abstaining from alcohol. Females should also be screened for undiagnosed cardiovascular risks.

Indexed as

Free Tissue FlapsHead and Neck NeoplasmsPlastic Surgery ProceduresPostoperative ComplicationsAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesRisk Factorscomplicationsfree flaphead and neck surgeryheparinperioperative medicationpostoperative carepreoperative preparation

Identifiers

PMID40862499
PMCPMC12501922

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Registered trials

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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.