Moellmann Henriette Louise, Karnatz Nadia, Degirmenci Ilkan, Rana Majeed
Cranio-and-Maxillo Facial Surgery, University Hospital Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
Department of Oral, Maxillofacial and Facial Plastic Surgery, Evangelical Hospital Bethesda, 41061 Mönchengladbach, Germany.
J Pers Med. 2024 Oct 14;14(10):1061. doi: 10.3390/jpm14101061.
The use of microvascular grafts is the gold standard in oral and maxillofacial surgery for the reconstruction of soft tissue and bony and combined defects. Graft loss is one of the most serious complications in the field of reconstructive surgery. A comprehensive analysis of factors influencing this is, therefore, essential.
This hypothesis-generating study analyzed 251 patient cases of oral and maxillofacial surgery at the University Hospital Düsseldorf from 2016 to 2020 regarding patient- and therapy-specific parameters for their impact on graft survival.
Statistically significant influencing factors were found among the 80 parameters examined: treatment with antiplatelet medication and a BMI ≥ 24.5 at the time of surgery had a positive influence on graft survival, while existing diabetes mellitus, atrial fibrillation, tracheostomy, and a longer operation time had a statistically relevant negative influence.
This work demonstrates the relevance of patient-specific risk stratification and the need for further research to develop a valid risk profile. Identifying high-risk patients with medium-sized defects, where alternatives to microvascular reconstruction are available, appears to be crucial for the clinical outcome.
在口腔颌面外科中，使用微血管移植物是软组织、骨组织及复合缺损重建的金标准。移植物丢失是重建外科领域最严重的并发症之一。因此，全面分析影响这一情况的因素至关重要。
这项产生假设的研究分析了2016年至2020年在杜塞尔多夫大学医院进行的251例口腔颌面外科患者病例，探讨患者及治疗相关参数对移植物存活的影响。
在所检查的80项参数中发现了具有统计学意义的影响因素：使用抗血小板药物治疗以及手术时BMI≥24.5对移植物存活有积极影响，而现有的糖尿病、心房颤动、气管切开术以及较长的手术时间则具有统计学上相关的负面影响。
这项研究表明了患者特异性风险分层的相关性以及开展进一步研究以建立有效风险模型的必要性。识别有中等大小缺损的高危患者，对于临床结果而言，在有微血管重建替代方案的情况下似乎至关重要。
