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Higher Complication Rates in Self‐Inflicted Gunshot Wounds After Microvascular Free Tissue Transfer
Author(s) -
Sokoya Mofiyinfolu,
Vincent Aurora G.,
Joshi Rohan,
Kadakia Sameep,
Kohlert Scott,
Lee Thomas S.,
Saman Masoud,
Ducic Yadranko
Publication year - 2019
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27391
Subject(s) - medicine , surgery , gunshot wound , complication , retrospective cohort study , confidence interval , free flap , contracture
Objectives/Hypothesis Microvascular free tissue transfer is often employed to reconstruct significant facial defects from ballistic injuries. Herein, we present our comparison of complications between self‐inflicted and non–self‐inflicted gunshot wounds after microvascular free tissue transfer. Study Design Retrospective case review. Methods Approval was obtained from the JPS institutional review board. We performed a retrospective review of cases of ballistic facial injuries between October 1997 and September 2017 that underwent vascularized free tissue transfer for reconstruction. Comparisons were made between self‐inflicted and non–self‐inflicted gunshot wounds after microvascular free tissue transfer. The χ 2 test was used for all comparisons. P value and 95% confidence interval (CI) were reported. Results There were 73 patients requiring free flap reconstruction after gunshot wounds to the face during the study period. There was a statistically significant difference in the rates of nonunion between self‐inflicted and non–self‐inflicted wounds ( P = .02, 95% CI: 0.9 to 35.8) There were also no significant differences in flap failure ( P = .10, 95% CI: −2.8 to 24.2), plate exposure ( P = .28, 95% CI: −6.7 to 33.0), wound infection ( P = .40, 95% CI: −8.9 to 31.2), scar contracture ( P = .60, 95% CI: −8.1 to 25.1), and fistula formation ( P = .13, 95% CI: −2.8 to 28.8) between patients with self‐inflicted and those with non–self‐inflicted wounds. Overall, complication rates were significantly higher in the self‐inflicted group compared to the non–self‐inflicted group ( P < .0001, 95% CI: 32.6 to 68.6). Conclusions Patients with self‐inflicted injuries had more complications postoperatively than those with non–self‐inflicted injuries. This is likely helpful in surgical planning and patient counseling. Level of Evidence 4 Laryngoscope , 129:837–840, 2019