CC BY-NC-ND 4.0 · J Hand Microsurg 2021; 13(02): 101-108
DOI: 10.1055/s-0040-1715557
Original Article

Thirty-Day Outcomes following Upper Extremity Flap Reconstruction

Thomas Wright
1  Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States
,
Daniel Donato
2  Division of Plastic Surgery, Department of Surgery, University of Texas Medical Branch, Texas, United States
,
1  Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States
,
David Magno-Padron
1  Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States
,
Jayant Agarwal
1  Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States
› Author Affiliations

Abstract

Introduction Flap reconstructions of upper extremity defects are challenging procedures. It is important to understand the surgical outcomes of upper extremity flap reconstruction, as well as associations between preoperative/perioperative variables and complications.

Materials and Methods The National Surgical Quality Improvement Program (NSQIP) database was queried for patients from 2005 to 2016 who underwent flap reconstruction of an upper extremity defect. Patient and perioperative variables were collected for identified patients and assessed for associations with rates of any complication and major complications.

Results On multivariate analysis, American Society of Anesthesiologists (ASA) classification >2, bleeding disorder, preoperative steroid use, free flap reconstruction, wound classification other than clean, and nonplastic surgeon specialty were independently associated with any complications. Bleeding disorder, ASA classification >2, male gender, wound classification other than clean, and preoperative anemia were independently associated with major complications. Free flap reconstruction was associated with increased length of stay, operative time, any complications, transfusions, and unplanned reoperations.

Conclusion There is an association between complications in patients undergoing upper extremity free flap reconstruction and ASA classification >2, preoperative anemia, preoperative steroid use, bleeding disorders, and contaminated wounds. Male patients may require more thorough counseling in activity restriction following reconstruction. Free flaps for upper extremity reconstruction will require increased planning to reduce the chance of complications.

Supplementary Material



Publication History

Publication Date:
17 September 2020 (online)

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