头颈部创伤后的游离皮瓣重建。

Free flap reconstruction following head and neck trauma.

机构信息

Department of Otolaryngology - Head and Neck Surgery, University of Miami, Miami, Florida, USA.

Surgical Care Division, Miami Veterans Affairs Health Care System, Miami, Florida, USA.

出版信息

Head Neck. 2024 Dec;46(12):2981-2992. doi: 10.1002/hed.27867. Epub 2024 Jul 10.

DOI:10.1002/hed.27867

PMID:38984564

Abstract

BACKGROUND

Free flap (FF) reconstruction of traumatic injuries to the head and neck is uncommon.

METHODS

Multi-institutional retrospective case series of patients undergoing FF reconstruction for a traumatic injury (n = 103).

RESULTS

Majority were gunshot wounds (GSW; 85%, n = 88) and motor vehicle accidents (11%, n = 11). Majority underwent osseous reconstruction (82%, n = 84). FF failures (9%, n = 9/103) occurred in GSW patients (100%, n = 9/9) and when multiple subsites were injured (89%, n = 8/9). Preoperative antibiotics correlated with lower rates of a neck washouts (4% vs. 19%) (p = 0.01) and 30-day readmissions (4% vs. 17%) (p = 0.02).

CONCLUSIONS

All FF failures occurred in the setting of a GSW and the majority involved multiple subsites. Preoperative antibiotics correlated with lower rates of postoperative washout procedures and 30-day readmission.

摘要

背景

头颈部创伤的游离皮瓣（FF）重建并不常见。

方法

对 103 例因创伤而行 FF 重建的患者进行多机构回顾性病例系列研究。

结果

大多数为枪伤（85%，n=88）和机动车事故（11%，n=11）。大多数患者接受了骨重建（82%，n=84）。FF 失败（9%，n=9/103）发生在枪伤患者（100%，n=9/9）和多个部位受伤的患者（89%，n=8/9）中。术前使用抗生素与较低的颈部冲洗（4%比 19%）（p=0.01）和 30 天再入院率（4%比 17%）（p=0.02）相关。