Klietz Marie-Luise, Mewe Chiara, Wiebringhaus Philipp, Hirsch Tobias, Aitzetmüller Matthias Michael, Kückelhaus Maximilian
Department for Plastic and Reconstructive Surgery, Institut for Muskuloskeletal Medicine, Westfälische Wilhelms-University, 48149 Münster, Germany.
Department for Plastic and Reconstructive Surgery, Fachklinik Hornheide, 48157 Münster, Germany.
Healthcare (Basel). 2023 Jan 31;11(3):403. doi: 10.3390/healthcare11030403.
(1) Background: Postoperative flap loss and wound healing disorders are severe complications after microsurgical free flap surgery. Despite multiple clinical observations, a possible influence of season and external temperature on outcome are largely missing. (2) Methods: Retrospectively, data were collected from 151 patients receiving microsurgical free flaps from March 2018 to August 2019. Patients were divided into two cohorts. The winter group includes all patients who underwent surgery from October 2018 to March 2019 and the summer group al those who underwent surgery from April 2018 to September 2018. Data included demographic information, pre-existing conditions, flap characteristics, and postoperative complications like flap losses and wound healing problems. External temperatures during the first 14 postoperative days were documented and the predictor of flap loss and wound healing disorders was detected. (3) Results: In the winter group (October-March; Ø 7.24 °C) 72 patients (46 female, 24 males; Ø 57.0 years) and in the summer group (April-September; Ø 18.79 °C) 81 patients (48 female, 33 males; Ø 56.0 years) received free flap surgery. There were no significant differences in demography (age: = 0.593; gender: = 0.419; BMI: = 0.141). We found a significant increase in flap loss during summer (χ(1) = 6.626; = 0.010; V = 0.209) strengthened by logistic regression analysis ( = 0.037; Exp(B) = 9.655). Additionally higher average temperatures 14 days postoperatively represents another main driver ( = 0.023, Exp(B) = 1.161) for postoperative flap loss. (4) Conclusions: The data confirm a significantly higher postoperative flap loss in the summer group. This information may potentially contribute to optimization of perioperative management and planning of elective and semi-elective surgeries.
（1）背景：术后皮瓣丢失和伤口愈合障碍是显微外科游离皮瓣手术后的严重并发症。尽管有多项临床观察，但季节和外界温度对手术结果的可能影响在很大程度上仍未得到研究。（2）方法：回顾性收集了2018年3月至2019年8月接受显微外科游离皮瓣手术的151例患者的数据。患者被分为两个队列。冬季组包括2018年10月至2019年3月接受手术的所有患者，夏季组包括2018年4月至2018年9月接受手术的所有患者。数据包括人口统计学信息、既往病史、皮瓣特征以及术后并发症，如皮瓣丢失和伤口愈合问题。记录术后前14天的外界温度，并检测皮瓣丢失和伤口愈合障碍的预测因素。（3）结果：冬季组（10月至3月；平均7.24°C）72例患者（46例女性，24例男性；平均57.0岁），夏季组（4月至9月；平均18.79°C）81例患者（48例女性，33例男性；平均56.0岁）接受了游离皮瓣手术。人口统计学方面无显著差异（年龄：P = 0.593；性别：P = 0.419；体重指数：P = 0.141）。我们发现夏季皮瓣丢失显著增加（χ²(1) = 6.626；P = 0.010；V = 0.209），逻辑回归分析进一步证实（P = 0.037；Exp(B) = 9.655）。此外，术后14天较高的平均温度是术后皮瓣丢失的另一个主要驱动因素（P = 0.023，Exp(B) = 1.161）。（4）结论：数据证实夏季组术后皮瓣丢失显著更高。这一信息可能有助于优化围手术期管理以及择期和半择期手术的规划。
