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Reconstruction of the Foot and Ankle Using Pedicled or Free Flaps: Perioperative Flap Survival Analysis

Li, Xiucun ; Cui, Jianli ; Maharjan, Suraj ; Lu, Laijin ; Gong, Xu Santanelli, di Pompeo d'Illasi, Fabio

PloS one, 2016-12, Vol.11 (12), p.e0167827-e0167827 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
Reconstruction of the Foot and Ankle Using Pedicled or Free Flaps: Perioperative Flap Survival Analysis
Autor: Li, Xiucun ; Cui, Jianli ; Maharjan, Suraj ; Lu, Laijin ; Gong, Xu
Santanelli, di Pompeo d'Illasi, Fabio
Assuntos: Anastomosis ; Ankle ; Ankle - surgery ; Ankle injuries ; Biology and Life Sciences ; Care and treatment ; Confidence intervals ; Correlation analysis ; Defects ; Diabetes ; Feet ; Flaps ; Foot - surgery ; Foot diseases ; Gangrene ; Health risks ; Hospitals ; Humans ; Hypertension ; Identification methods ; Infections ; Inflammation ; Injuries ; Medicine and Health Sciences ; Meta-analysis ; Microsurgery ; Microvasculature ; Multivariate analysis ; Necrosis ; Patients ; Plastic surgery ; Postoperative infection ; Reconstruction ; Reconstructive Surgical Procedures - methods ; Regression analysis ; Regression models ; Retrospective Studies ; Risk analysis ; Risk factors ; Skin ; Statistical analysis ; Statistical significance ; Surgery ; Surgery, Plastic ; Surgical Flaps ; Survival ; Survival analysis ; Systematic review ; Trauma ; Wound infection
É parte de: PloS one, 2016-12, Vol.11 (12), p.e0167827-e0167827
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Conceptualization: XL XG JC.Data curation: SM LL.Formal analysis: XL XG JC.Funding acquisition: None.Investigation: XL SM LL.Methodology: XL XG.Project administration: XL XG.Resources: XL XG JC.Software: XL SM LL.Supervision: SM LL.Validation: JC LL.Visualization: XL JC SM.Writing – original draft: XL XG.Writing – review & editing: XL XG JC.
Competing Interests: The authors have declared that no competing interests exist.
Descrição: The purpose of this study is to determine the correlation between non-technical risk factors and the perioperative flap survival rate and to evaluate the choice of skin flap for the reconstruction of foot and ankle. This was a clinical retrospective study. Nine variables were identified. The Kaplan-Meier method coupled with a log-rank test and a Cox regression model was used to predict the risk factors that influence the perioperative flap survival rate. The relationship between postoperative wound infection and risk factors was also analyzed using a logistic regression model. The overall flap survival rate was 85.42%. The necrosis rates of free flaps and pedicled flaps were 5.26% and 20.69%, respectively. According to the Cox regression model, flap type (hazard ratio [HR] = 2.592; 95% confidence interval [CI] (1.606, 4.184); P < 0.001) and postoperative wound infection (HR = 0.266; 95% CI (0.134, 0.529); P < 0.001) were found to be statistically significant risk factors associated with flap necrosis. Based on the logistic regression model, preoperative wound bed inflammation (odds ratio [OR] = 11.371,95% CI (3.117, 41.478), P < 0.001) was a statistically significant risk factor for postoperative wound infection. Flap type and postoperative wound infection were both independent risk factors influencing the flap survival rate in the foot and ankle. However, postoperative wound infection was a risk factor for the pedicled flap but not for the free flap. Microvascular anastomosis is a major cause of free flap necrosis. To reconstruct complex or wide soft tissue defects of the foot or ankle, free flaps are safer and more reliable than pedicled flaps and should thus be the primary choice.
Editor: United States: Public Library of Science
Idioma: Inglês

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Reconstruction of the Foot and Ankle Using Pedicled or Free Flaps: Perioperative Flap Survival Analysis

Li, Xiucun ; Cui, Jianli ; Maharjan, Suraj ; Lu, Laijin ; Gong, Xu Santanelli, di Pompeo d'Illasi, Fabio

United States: Public Library of Science

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