Perioperative Risk Factors for Radial Forearm-Free Flap Complications

Purpose: To determine perioperative risk factors predicted complications in elderly Chinese patients undergoing oral and maxillofacial reconstruction with radial forearm free flaps (RFFF). Patients and Methods: The authors implemented a retrospective study and enrolled a sample of patients at least 65-year old who underwent resection of oral and maxillofacial tumors and RFFF reconstruction from January 2011 to June 2018. Predictor variables were divided into: demographic variables (gender, age, weight, comorbidities, history of smoking, radiotherapy history, primary lesions); hemodynamic (preoperative and postoperative hemoglobin and albumin level, blood loss, blood transfusion, urine output (mL), and rate (mL/kg/h), and infusion rates for crystalloids and colloids (mL/kg/h, and volumes given intraoperatively and postoperatively for 24 hours); anesthetic and surgical (American Society of Anesthesiologists classification, visual analogue score, duration of tourniquet, and operation). The primary outcome was the presence of postoperative complications (yes/no), and secondary outcome was types of complications (medical and surgical). All the variables were analyzed by univariate and multivariable analysis and statistical significance was set at a P 
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Original Articles Source Type: research

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Background: Approximately one in 2000 babies are born with craniosynostosis, and primary open repair is typically performed before 1 year of age. Historically, the procedure has been associated with nearly 100 percent transfusion rates. To decrease the rates of transfusion, the authors’ center has developed a novel multimodal blood conservation protocol. Methods: The authors administered their standard of care to children aged 1 year or younger undergoing primary repair of craniosynostosis between 2008 and 2014. In 2014, the authors implemented the following protocol: (1) preoperative erythropoietin and ferrous ...
Source: Plastic and Reconstructive Surgery - Category: Cosmetic Surgery Tags: Pediatric/Craniofacial: Original Articles Source Type: research
Conclusions: Although adverse events following cleft palate surgery are rare, systemic disease remains the greatest predictor for readmission and reoperation. Neurologic and pulmonary diseases are the greatest systemic risk factors. Intraoperative adverse events requiring blood transfusion are the greatest surgical risk factor for post-surgical complications.
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Original Articles Source Type: research
CONCLUSION: An EACA bolus of 100 mg/kg followed by an infusion of 40 mg/kg was associated with a lower calculated blood loss compared to the group who received 100 mg/kg EACA and ≤ 30 mg/kg infusion. This article is protected by copyright. All rights reserved. PMID: 31141266 [PubMed - as supplied by publisher]
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
Conclusion: Syndromic and complex craniosynostosis may safely be managed with initial PVDO followed by FOA, with some increased wound closure difficulty.
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Original Articles Source Type: research
Background: The American College of Surgeons’ National Surgical Quality Improvement Program-Pediatric (NSQIP-P) risk calculator was developed based on national data. There have been no studies assessing the risk calculator's performance in pediatric neurosurgery. The authors aimed to evaluate the predictions from the risk calculator compared to our single institution experience in craniosynostosis surgery. Methods: Outcomes from craniosynostosis surgeries performed between 2012 and 2016 at our academic pediatric hospital were evaluated using the NSQIP-P risk calculator. Descriptive statistics were performed comp...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Original Articles Source Type: research
Tranexamic acid (TXA), a synthetic lysine analogue, is a potent antifibrinolytic agent that inhibits both plasminogen and plasmin. Tranexamic acid gained worldwide recognition in the 2010 Clinical Randomization of an Antifibrinolytic in Significant Hemorrhage (CRASH- 2) trial, a multinational randomized placebo-controlled trial of TXA in adult trauma patients with significant bleeding.1 TXA significantly reduced the risk of death as a result of bleeding by about a sixth and reduced the risk of all cause mortality by about a tenth. In 2011, TXA was recommended by the World Health Organization as an essential medicine for th...
Source: British Journal of Anaesthesia - Category: Anesthesiology Source Type: research
Abstract: Sagittal craniosynostosis remains the most common type of isolated craniosynostosis, accounting for nearly half of all nonsyndromic cases. The clinical diagnosis is typically made on the basis of a scaphocephalic head shape and is confirmed by computed tomography or magnetic resonance imaging. The current review examines the major surgical options for correction of isolated sagittal craniosynostosis, including their complications and short- and long-term outcomes. Reconstructive techniques have benefited from advances in perioperative anesthesia monitoring and improved safety of blood transfusion. Although extens...
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Review Articles Source Type: research
Abstract: The American College of Surgeons and the American Pediatric Surgical Association collaborate to provide pediatric hospitals with multispeciality surgical outcomes data through the Pediatric National Surgical Quality Improvement Program (NSQIP Peds). The authors used this national multicenter database to describe 30-day outcomes from craniosynostosis surgery and identify associations with perioperative events and blood transfusion. Data from NSQIP Peds were used to describe children undergoing craniosynostosis surgery. The authors examined statistical association of clinical risk factors with the defined end poin...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Original Articles Source Type: research
Background: Perioperative bleeding is a common side effect of rhinoplasty which may impose the blood transfusion to the patients. As a result of risks and cost of blood transfusion, this study is planned to reduce blood loss in these surgeries. Since tranexamic acid (TXA) has been reported to reduce bleeding and subsequent possible need for blood transfusion, the purpose of this study was to evaluate the efficacy of oral TXA on blood loss during rhinoplasty. Methods and Materials: In this double-blind, randomized, placebo-controlled clinical trial, 50 participants underwent rhinoplastic surgery. These participants were di...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Original Articles Source Type: research
Conclusions: During the past 20 years, the CIRPLAST team has offered free surgery with good outcomes and few complications, to more than 6000 cleft lip and/or palate patients in remote areas of Peru.
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Original Articles Source Type: research
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