Impact of preoperative and intraoperative management on outcomes in osteoradionecrosis requiring free flap reconstruction

Academic Article


  • Background: Perioperative management of advanced osteoradionecrosis of the head and neck requiring free flap (FF) reconstruction varies. Our objectives included assessment of practice patterns and outcomes. Methods: Multi-institutional, retrospective review of FF reconstruction for head and neck osteoradionecrosis (n = 260). Results: Administration of preoperative antibiotics did not correlate with reduction in postoperative complications. Preoperative alcohol use correlated with higher rates of hardware exposure (p = 0.03) and 30-day readmission (p = 0.04). Patients with FF compromise had higher TSH (p = 0.04) and lower albumin levels (p = 0.005). Prealbumin levels were lower in patients who required neck washouts (p = 0.02) or a second FF (p = 0.03). TSH levels were higher in patients undergoing postoperative debridement (p = 0.03) or local flap procedures (p = 0.04). Conclusion: Malnutrition, hypothyroidism, and substance abuse correlated with a higher incidence of postoperative wound complications in patients undergoing FF reconstruction for advanced osteoradionecrosis. Preoperative antibiotics use did not correlate with a reduction in postoperative wound complications.
  • Authors

    Digital Object Identifier (doi)

    Pubmed Id

  • 28316499
  • Author List

  • Mayland E; Curry JM; Wax MK; Thomas CM; Swendseid BP; Kejner AE; Kain JJ; Cannady SB; Miles BA; DiLeo M
  • Start Page

  • 698
  • End Page

  • 709
  • Volume

  • 44
  • Issue

  • 3