Risk factors for flap dehiscence and/or necrosis following standard rotational flap in cranial vault osteomyelitis without intracranial involvement: A retrospective study.

IF 2.2 3区 医学 Q2 Dentistry Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2024-12-04 DOI:10.1016/j.jormas.2024.102187
Benjamin Frech, Chidpong Siritongtaworn, Chayawee Muangchan, Chatpong Tangmanee, Keskanya Subbalekha, Nattapong Sirintawat, Jean-Paul Meningaud, Poramate Pitak-Arnnop, Christian Stoll
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Abstract

Objectives: The study aimed to estimate the incidence of flap dehiscence and/or necrosis (FD/N) following standard rotational flap (SRF) surgery for cranial vault osteomyelitis without intracranial involvement (CVO) and to identify factors associated with these complications.

Methods: A retrospective study was conducted using chart reviews of patients who underwent SRF to cover CVO defects over a 10-year period. Twenty-one predictor variables were analysed, categorised into demographic, health status, anatomic, and surgical factors. The primary outcome was the occurrence of FD/N. Descriptive, bi- and multivariate regression analyses were used to identify variables significantly associated with FD/N (P ≤ 0.05).

Results: The study included 154 subjects who underwent SRF (26.6 % female), with a mean age of 75.6 ± 12.8 years (range, 26-94). The incidence of FD/N was 5.2 %. Multivariate analysis revealed that smoking (odds ratio [OR] 1.07; P = 0.04), second surgery (OR 1.18; P < 0.001), compromised scalp vascularity (OR 1.1; P = 0.007), and defects at the central scalp and vertex (OR 1.08; P = 0.02) were statistically significantly associated with an increased risk of FD/N.

Conclusions: FD/N is an infrequent complication following SRF for CVO. Significant modifiable risk factors included smoking, multiple flap operations, compromised scalp vascularity, and defects at the central scalp and vertex. Addressing these factors may help reduce the risk of FD/N in this patient population. Future research should investigate outcomes among different flap types for CVO defects.

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2.20
自引率
9.10%
发文量
305
期刊介绍: J Stomatol Oral Maxillofac Surg publishes research papers and techniques - (guest) editorials, original articles, reviews, technical notes, case reports, images, letters to the editor, guidelines - dedicated to enhancing surgical expertise in all fields relevant to oral and maxillofacial surgery: from plastic and reconstructive surgery of the face, oral surgery and medicine, … to dentofacial and maxillofacial orthopedics. Original articles include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey Platforms.
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