Premium
Consensus of free flap complications: Using a nomenclature paradigm in microvascular head and neck reconstruction
Author(s) -
Mady Leila J.,
Poonia Seerat K.,
Baddour Khalil,
Snyder Vusala,
Kurukulasuriya Chareeni,
Frost Ariel S.,
Cannady Steven B.,
Chinn Steven B.,
Fancy Tanya,
Futran Neal,
Hanasono Matthew M.,
Lewis Carol M.,
Miles Brett A.,
Patel Urjeet,
Richmon Jeremy D.,
Wax Mark K.,
Yu Peirong,
Solari Mario G.,
Sridharan Shaum
Publication year - 2021
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26789
Subject(s) - medicine , surgery , seroma , free flap , hematoma , thrombosis , nonunion , venous thrombosis , radiology , complication
Background We aim to define a set of terms for common free flap complications with evidence‐based descriptions. Methods Clinical consensus surveys were conducted among a panel of head and neck/reconstructive surgeons ( N = 11). A content validity index for relevancy and clarity for each item was computed and adjusted for chance agreement (modified kappa, K ). Items with K < 0.74 for relevancy (i.e., ratings of “good” or “fair”) were eliminated. Results Five out of nineteen terms scored K < 0.74. Eliminated terms included “vascular compromise”; “cellulitis”; “surgical site abscess”; “malocclusion”; and “non‐ or mal‐union.” Terms that achieved consensus were “total/partial free flap failure”; “free flap takeback”; “arterial thrombosis”; “venous thrombosis”; “revision of microvascular anastomosis”; “fistula”; “wound dehiscence”; “hematoma”; “seroma”; “partial skin graft failure”; “total skin graft failure”; “exposed hardware or bone”; and “hardware failure.” Conclusion Standardized reporting would encourage multi‐institutional research collaboration, larger scale quality improvement initiatives, the ability to set risk‐adjusted benchmarks, and enhance education and communication.