Journal article
Free Flap Outcomes for Head and Neck Surgery in Patients with COVID-19
The Laryngoscope, Vol.134(11), pp.4521-4526
11/2024
DOI: 10.1002/lary.31159
PMCID: PMC12375219
PMID: 37937733
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) affects the vascular system, subjecting patients to a hypercoagulable state. This is of particular concern for the success of microvascular free flap reconstruction. This study aims to report head and neck free flap complications in patients with COVID-19 during the perioperative period. We believe these patients are more likely to experience flap complications given the hypercoagulable state. METHODS This is a multi-institutional retrospective case series of patients infected with COVID-19 during the perioperative period for head and neck free flap reconstruction from March 2020 to January 2022.RESULTSData was collected on 40 patients from 14 institutions. Twenty-one patients (52.5%) had a positive COVID-19 test within 10 days before surgery and 7 days after surgery. The remaining patients had a positive test earlier than 10 days before surgery. A positive test caused a delay in surgery for 16 patients (40.0%) with an average delay of 44.7 days (9-198 days). Two free flap complications (5.0%) occurred with no free flap deaths. Four patients (10.0%) had surgical complications and 10 patients had medical complications (25.0%). Five patients (12.5%) suffered from postoperative COVID-19 pneumonia. Three deaths were COVID-19-related and one from cancer recurrence during the study period. CONCLUSION Despite the heightened risk of coagulopathy in COVID-19 patients, head and neck free flap reconstructions in patients with COVID-19 are not at higher risk for free flap complications. However, these patients are at increased risk of medical complications. LEVEL OF EVIDENCE 4 Laryngoscope, 2023.
Details
- Title: Subtitle
- Free Flap Outcomes for Head and Neck Surgery in Patients with COVID-19
- Creators
- Aaron Domack - Loyola University Medical CenterMorgan M Sandelski - Loyola University Medical CenterSyed AliKeith E Blackwell - University of California, Los AngelesMarisa Buchakjian - University of IowaAndrés M Bur - University of Kansas Medical CenterSteven B Cannady - University of PennsylvaniaCarlos X Castellanos - University of Southern CaliforniaYadranko DucicTamer A Ghanem - Henry Ford Health SystemAndrew T Huang - Baylor College of MedicineRyan S Jackson - Washington University in St. LouisNiels Kokot - University of Southern CaliforniaShawn Li - University Hospitals of ClevelandPatrik Pipkorn - Washington University in St. LouisSidharth V Puram - Washington University in St. LouisRod Rezaee - University Hospitals of ClevelandKarthik Rajasekaran - University of PennsylvaniaYelizaveta Shnayder - University of Kansas Medical CenterUttam K Sinha - University of Southern CaliforniaDaniel Sukato - University of California, Los AngelesNeeraj Suresh - University of PennsylvaniaAkina Tamaki - University Hospitals of ClevelandCarissa M Thomas - University of Alabama at BirminghamEric J Thorpe - Loyola University Medical CenterMark K Wax - Oregon Health & Science UniversitySara Yang - Oregon Health & Science UniversityAndrea Ziegler - Loyola University Medical CenterAmy L Pittman - Loyola University Medical Center
- Resource Type
- Journal article
- Publication Details
- The Laryngoscope, Vol.134(11), pp.4521-4526
- DOI
- 10.1002/lary.31159
- PMID
- 37937733
- PMCID
- PMC12375219
- NLM abbreviation
- Laryngoscope
- ISSN
- 0023-852X
- eISSN
- 1531-4995
- Language
- English
- Electronic publication date
- 11/08/2023
- Date published
- 11/2024
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984507024702771
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