Chick L R, Walton R L, Reus W, Colen L, Sasmor M
Division of Plastic and Reconstructive Surgery, University of Massachusetts Medical Center, Worcester.
Plast Reconstr Surg. 1992 Jul;90(1):87-94. doi: 10.1097/00006534-199207000-00013.
Microsurgical transfer of tissue has become a primary tool of the reconstructive surgeon. The elderly, as a growing segment of our society, are requiring free-tissue transfers in proportion to their numbers. To investigate the potential morbidity of free-tissue transfers in the elderly, we studied consecutive populations of 31 patients above the age of 65 years and 90 patients below the age of 65 years. Complication rates were 65 and 49 percent, respectively. Premorbid medical conditions were present in 87 percent of patients 65 years and older and in 72 percent of those under 65 years. Medically related complications in free-tissue transfers, previously unreported in the literature, were 35 percent in the elderly group and 10 percent in the younger group. Wound-healing complications were seen in equal proportions between groups. The rates of wound and medically related complications observed in the elderly group were nearly double those observed in the younger group; however, after correction for the presence of preexisting medical conditions, no significant differences were seen between the two groups. These observations suggest that age alone is not a variable in risk for free-tissue transfers. Elective microsurgery can be performed in the elderly patient with a high expectation of success.
组织的显微外科转移已成为重建外科医生的主要工具。老年人作为我们社会中不断增长的一部分，正按其数量比例需要进行游离组织移植。为了研究老年人游离组织移植的潜在发病率，我们对连续的两组人群进行了研究，一组是31名65岁以上的患者，另一组是90名65岁以下的患者。并发症发生率分别为65%和49%。65岁及以上患者中有87%存在病前医疗状况，65岁以下患者中有72%存在病前医疗状况。游离组织移植中与医疗相关的并发症在文献中此前未被报道，老年组为35%，年轻组为10%。两组伤口愈合并发症的比例相同。老年组观察到的伤口和与医疗相关的并发症发生率几乎是年轻组的两倍；然而，在对存在的既往医疗状况进行校正后，两组之间未观察到显著差异。这些观察结果表明，仅年龄并非游离组织移植风险的一个变量。对老年患者进行择期显微外科手术有望取得很高的成功率。
