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上肢游离皮瓣移植:基于国家外科质量改进计划数据库的分析

Upper Extremity Free Flap Transfers: An Analysis of the National Surgical Quality Improvement Program Database.

作者信息

Beyer George A, Dua Karan, Shah Neil V, Scollan Joseph P, Newman Jared M, Mithani Suhail K, Koehler Steven M

机构信息

Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, New York, United States.

Department of Plastic, Maxillofacial, and Oral Reconstructive Surgery, Duke University Medical Center, Durham, North Carolina, United States.

出版信息

J Hand Microsurg. 2020 Sep 22;14(3):245-250. doi: 10.1055/s-0040-1717828. eCollection 2022 Jul.

Abstract

We evaluated the demographics, flap types, and 30-day complication, readmission, and reoperation rates for upper extremity free flap transfers within the National Surgical Quality Improvement Program (NSQIP) database.  Upper extremity free flap transfer patients in the NSQIP from 2008 to 2016 were identified. Complications, reoperations, and readmissions were queried. Chi-squared tests evaluated differences in sex, race, and insurance. The types of procedures performed, complication frequencies, reoperation rates, and readmission rates were analyzed.  One-hundred-eleven patients were selected (mean: 36.8 years). Most common upper extremity free flaps were muscle/myocutaneous (45.9%) and other vascularized bone grafts with microanastomosis (27.9%). Thirty-day complications among all patients included superficial site infections (2.7%), intraoperative transfusions (7.2%), pneumonia (0.9%), and deep venous thrombosis (0.9%). Thirty-day reoperation and readmission rates were 4.5% and 3.6%, respectively. The mean time from discharge to readmission was 12.5 days.  Upper extremity free flap transfers could be performed with a low rate of 30-day complications, reoperations, and readmissions.

摘要

我们在国家外科质量改进计划(NSQIP)数据库中评估了上肢游离皮瓣移植患者的人口统计学特征、皮瓣类型以及30天并发症、再入院率和再次手术率。

确定了2008年至2016年NSQIP中的上肢游离皮瓣移植患者。查询了并发症、再次手术和再入院情况。采用卡方检验评估性别、种族和保险方面的差异。分析了所进行的手术类型、并发症发生率、再次手术率和再入院率。

共选择了111例患者(平均年龄:36.8岁)。最常见的上肢游离皮瓣是肌肉/肌皮瓣(45.9%)和其他带微血管吻合的血管化骨移植瓣(27.9%)。所有患者的30天并发症包括表浅部位感染(2.7%)、术中输血(7.2%)、肺炎(0.9%)和深静脉血栓形成(0.9%)。30天再次手术率和再入院率分别为4.5%和3.6%。出院至再入院的平均时间为12.5天。

上肢游离皮瓣移植的30天并发症、再次手术和再入院率较低。

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