Evidence map›Paper›PMID 41863641›Full record

ArticleOral and maxillofacial surgery2026

Complication drivers in head and neck free flap surgery: A single-center predictive analysis.

Jakob Fenske, Leonard Knoedler, Michael Alfertshofer, Friedrich Mrosk, Philipp Lampert, Christian Doll, Kilian Kreutzer, Max Heiland, Steffen Koerdt, Carsten Rendenbach

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In one paragraph

Article in Oral and maxillofacial surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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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.

2 · The registry

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Jakob FenskeDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany. jakob.fenske@charite.de.
Leonard KnoedlerDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Michael AlfertshoferDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Friedrich MroskDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Philipp LampertDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Christian DollDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Kilian KreutzerDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Max HeilandDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Steffen Koerdt *Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Carsten Rendenbach *Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHead and neck free flap (HNFF) surgery is essential in reconstructive surgery, addressing complex defects with tailored approaches. Despite high success rates, complications remain significant, influenced by patient comorbidities, flap types, and surgical complexity. This study aimed to analyze predictors of postoperative complications to improve patient outcomes.

methodsThis monocentric retrospective cohort study included patients undergoing microvascular free flap reconstruction for head and neck defects between April 2017 and July 2023. The primary outcome was flap-specific postoperative complications, including flap loss, recipient site wound healing disorders (WHD), partial flap necrosis, or anastomotic insufficiency.

resultsAmong 1050 patients, the free flap success rate was 94%, with 59 flap losses. Complications occurred in 44% of patients, most commonly WHD (29%). Prior head and neck radiotherapy was associated with anastomosis revision (OR 2.13; p = 0.02) and flap loss (OR 2.06; p = 0.02). Female sex increased the risk of flap loss (OR 2.24; p = 0.004). Alcohol abuse elevated the risk of WHD (OR 1.81; p = 0.003) and partial flap necrosis (OR 2.19; p = 0.001). Infection risk was influenced by age (OR 0.98; p = 0.01), bleeding disorders (OR 5.37; p = 0.003), and prior microvascular reconstruction (OR 2.08; p = 0.008). Increased surgical experience only slightly correlated with higher flap loss rates (OR 1.06; p = 0.02).

conclusionFree flap surgery is effective in head and neck reconstruction, though specific risk factors contribute to complications. Further research is needed to mitigate these risks. Surgical experience is essential for complex cases but is not a primary, clinically relevant predictor of complications in high-volume training centers.

Indexed as

Free Tissue FlapsHead and Neck NeoplasmsPlastic Surgery ProceduresPostoperative ComplicationsAdultAgedFemaleHumansMaleMiddle AgedNecrosisRetrospective StudiesRisk FactorsFree flap reconstructionMaxillofacial surgeryMicrovascular reconstructionOutcome analysisPrior radiotherapySurgeon experience

Identifiers

PMID41863641
PMCPMC13005771

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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.