The role of postoperative hematoma on free flap compromise

Faisal I. Ahmad, Deniz Gerecci, Javier D. Gonzalez, Jessica J. Peck, Mark Wax

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives/Hypothesis Hematomas may develop in the postoperative setting after free tissue transfer. When hematomas occur, they can exert pressure on surrounding tissues. Their effect on the vascular pedicle of a free flap is unknown. We describe our incidence of hematoma in free flaps and outcomes when the flap is compromised. Study Design Retrospective chart review of 1,883 free flaps performed between July 1998 and June 2014 at a tertiary referral center. Methods Patients with free flap compromise due to hematoma were identified. Etiology, demographic data, and outcomes were evaluated. Results Eighty-eight (4.7%) patients developed hematomas. Twenty (22.7%) of those had flap compromise. Twelve compromises (60%) showed evidence of pedicle thrombosis. The salvage rate was 75% versus 54% in 79 flaps with compromise from other causes (P = .12). Mean time to detection of the hematoma was 35.3 hours in salvaged flaps compared to 91.6 hours in unsalvageable flaps (P = .057). Time to operating room (OR) from detection was 2.8 hours in salvageable flaps compared to 12.4 hours in nonsalvageable flaps (P = .053). The salvage rate for flaps that returned to the OR in

Original languageEnglish (US)
Pages (from-to)1811-1815
Number of pages5
JournalLaryngoscope
Volume125
Issue number8
DOIs
StatePublished - Aug 1 2015

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Free Tissue Flaps
Hematoma
Operating Rooms
Tertiary Care Centers
Blood Vessels
Thrombosis
Retrospective Studies
Demography
Pressure
Incidence

Keywords

  • flap compromise
  • Free tissue transfer
  • hematoma
  • microvascular

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Medicine(all)

Cite this

Ahmad, F. I., Gerecci, D., Gonzalez, J. D., Peck, J. J., & Wax, M. (2015). The role of postoperative hematoma on free flap compromise. Laryngoscope, 125(8), 1811-1815. https://doi.org/10.1002/lary.25285

The role of postoperative hematoma on free flap compromise. / Ahmad, Faisal I.; Gerecci, Deniz; Gonzalez, Javier D.; Peck, Jessica J.; Wax, Mark.

In: Laryngoscope, Vol. 125, No. 8, 01.08.2015, p. 1811-1815.

Research output: Contribution to journalArticle

Ahmad, FI, Gerecci, D, Gonzalez, JD, Peck, JJ & Wax, M 2015, 'The role of postoperative hematoma on free flap compromise', Laryngoscope, vol. 125, no. 8, pp. 1811-1815. https://doi.org/10.1002/lary.25285
Ahmad FI, Gerecci D, Gonzalez JD, Peck JJ, Wax M. The role of postoperative hematoma on free flap compromise. Laryngoscope. 2015 Aug 1;125(8):1811-1815. https://doi.org/10.1002/lary.25285
Ahmad, Faisal I. ; Gerecci, Deniz ; Gonzalez, Javier D. ; Peck, Jessica J. ; Wax, Mark. / The role of postoperative hematoma on free flap compromise. In: Laryngoscope. 2015 ; Vol. 125, No. 8. pp. 1811-1815.
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