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- Title
Consensus of free flap complications: Using a nomenclature paradigm in microvascular head and neck reconstruction.
- Authors
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
- Abstract
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.
- Subjects
FREE flaps; SKIN grafting; SURGICAL site; VENOUS thrombosis; NECK
- Publication
Head & Neck, 2021, Vol 43, Issue 10, p3032
- ISSN
1043-3074
- Publication type
Article
- DOI
10.1002/hed.26789