Pub Date : 2024-03-01Epub Date: 2023-02-24DOI: 10.1177/19433875231160346
Camilo Mosquera, Marina Morante Silva, Ashleigh M Weyh, Michael A Malik, Rui Fernandes
<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>Malnutrition has been found to have negative effects on the immune system and inflammatory responses, impairing the wound healing process. Free flap failure is a serious complication in patients undergoing microvascular reconstruction, as it increases patient morbidity, length of stay in the hospital, patient, and hospital costs, as well as causes the need for further surgical interventions<sup>1</sup>. Malnutrition is estimated to be present in 35-50% of head and neck cancer patients with higher rates in those experiencing hypo-oropharyngeal disease. This is often caused by functional and pain limitations from due to disease burden causing odynophagia and dysphagia. The Malnutrition Universal Screening Tool (MUST) is recommended for risk screening and provides three scores for risk classification: high, intermediate, and low<sup>2</sup>. We argue that the use of MUST as a preoperative assessment tool is useful to predict postoperative surgical site infection and delayed wound healing in patients that will undergo reconstruction with free flaps for head and neck defects.</p><p><strong>Methods: </strong>A retrospective cohort study was designed to include all subjects who underwent head and neck microvascular free tissue transfer at a single institution between 2013 and 2019. Primary and secondary reconstructions were included, for benign or malignant pathology, osteonecrosis, osteomyelitis, congenital defects, and trauma. The nutritional risk was evaluated using MUST, which analyzes body mass index, weight loss, and acute disease effect, to classify patients as low, intermediate, and high risk. We further divided the subjects into two comparison groups- low-intermediate and high risk. The primary outcome was surgical site complications and delayed wound healing. Data was analyzed as frequencies and means with standard deviations, as well as Fisher's exact test and t-test. P-values <0.05 were considered statistically significant. Analyses were done utilizing IBM SPSS Statistics Version 29.</p><p><strong>Results: </strong>131 subjects were included for data analysis, with 54 being considered low MUST risk, 12 intermediate risk (66 low-intermediate), and 65 were high risk. The mean BMI overall was 25.5 ±5.3, and 27.2 in the low-intermediate group, and 23.7 in the high-risk group. Eighty-two subjects experienced <5-pound weight loss in the preceding 6 months to surgery, while 17 lost between 5-10 pounds, and 23 lost 10< pounds. Cancer/osteonecrosis was the etiology for 54 (82%) subjects of the low-intermediate group, and 61 (92%) of the high-risk group (<i>P</i> = .089). The subjects classified in High-risk group according to the MUST score had 11% more surgical site complications (<i>P</i> = .120) and 13.7% more delayed wound healing and dehiscence(<i>P</i> = .09); only 3 subjects in the study presented total flap loss and they were all in the High-risk g
研究设计回顾性队列研究：营养不良会对免疫系统和炎症反应产生负面影响，损害伤口愈合过程。游离皮瓣失败是微血管重建患者的严重并发症，因为它会增加患者的发病率、住院时间、患者和医院的费用，并导致需要进一步的手术干预1。据估计，35%-50% 的头颈部癌症患者会出现营养不良，其中口咽下部疾病患者的营养不良率更高。这通常是由于疾病负担造成的功能和疼痛限制导致的吞咽困难和吞咽困难。营养不良通用筛查工具（MUST）被推荐用于风险筛查，并提供了三个风险分类分数：高、中、低2。我们认为，使用营养不良通用筛查工具作为术前评估工具有助于预测头颈部缺损游离皮瓣重建患者术后手术部位感染和伤口延迟愈合的情况：设计了一项回顾性队列研究，纳入2013年至2019年期间在一家机构接受头颈部微血管游离组织转移的所有受试者。研究对象包括因良性或恶性病变、骨坏死、骨髓炎、先天性缺损和创伤而进行的初次和二次重建。我们使用MUST对营养风险进行了评估，MUST分析了体重指数、体重减轻和急性疾病效应，将患者分为低风险、中风险和高风险。我们进一步将受试者分为两个对比组--中低风险组和高风险组。主要结果是手术部位并发症和伤口延迟愈合。数据分析采用频率、平均值和标准差，以及费雪精确检验和 t 检验。P值结果：131 名受试者被纳入数据分析，其中 54 人被认为是低 MUST 风险，12 人为中度风险（66 人为低中度风险），65 人为高度风险。总体平均体重指数为 25.5 ±5.3，中低风险组为 27.2，高风险组为 23.7。82名受试者经历了P = .089）。根据 MUST 评分被归入高风险组的受试者，其手术部位并发症发生率高出 11% (P = .120)，伤口延迟愈合和开裂发生率高出 13.7% (P = .09)；研究中只有 3 名受试者出现皮瓣完全脱落的情况，他们都属于高风险组。手术部位并发症、伤口延迟愈合率、部分或全部皮瓣缺失率并没有因为任何特定的合并症或病史（如放疗或化疗）而增加：总之，MUST评分高的受试者并发症和伤口愈合不良的几率更高，而急性疾病影响导致无期超过5天的受试者皮瓣全部脱落和手术部位并发症的风险更高。
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{"title":"Correction to: Robert Frost: Teaching and the Pleasure of Ulteriority","authors":"","doi":"10.1093/escrit/cgad025","DOIUrl":"https://doi.org/10.1093/escrit/cgad025","url":null,"abstract":"","PeriodicalId":43350,"journal":{"name":"ESSAYS IN CRITICISM","volume":"60 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139360912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"文学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal Article Samuel Richardson, Ford Madox Ford, and How to End a Novel Get access Melvyn New Melvyn New University of Florida, USA melnew@UFL.EDU Search for other works by this author on: Oxford Academic Google Scholar Essays in Criticism, Volume 73, Issue 3, July 2023, Pages 344–362, https://doi.org/10.1093/escrit/cgad031 Published: 20 September 2023
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Journal Article That’s Me All Right! Get access The Letters of Thom Gunn. Edited by Michael Nott, August Kleinzahler, and Clive Wilmer. Faber and Faber, 2021; £35. Andrew Dickinson Andrew Dickinson Barts and the London School of Medicine and Dentistry, UK andrew@styford.co.uk Search for other works by this author on: Oxford Academic Google Scholar Essays in Criticism, Volume 73, Issue 3, July 2023, Pages 368–378, https://doi.org/10.1093/escrit/cgad029 Published: 20 September 2023
期刊文章那是我好吧!获得Thom Gunn的信件。编辑:迈克尔·诺特，奥古斯特·克莱因扎勒和克莱夫·威尔默。Faber and Faber, 2021;£35。安德鲁·迪金森安德鲁·迪金森巴茨和伦敦医学和牙科学院，英国andrew@styford.co.uk搜索作者的其他作品:牛津学术谷歌学者评论论文，第73卷，第3期，2023年7月，368-378页，https://doi.org/10.1093/escrit/cgad029出版日期:2023年9月20日
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Journal Article A Valediction for Saskia Hamilton: 5 May 1967 – 7 June 2023 Get access Michael Autrey Michael Autrey Romney, West Virginia, USA mvksautrey@gmail.com Search for other works by this author on: Oxford Academic Google Scholar Essays in Criticism, Volume 73, Issue 3, July 2023, Pages 265–274, https://doi.org/10.1093/escrit/cgad026 Published: 20 September 2023
{"title":"A Valediction for Saskia Hamilton: 5 May 1967 – 7 June 2023","authors":"Michael Autrey","doi":"10.1093/escrit/cgad026","DOIUrl":"https://doi.org/10.1093/escrit/cgad026","url":null,"abstract":"Journal Article A Valediction for Saskia Hamilton: 5 May 1967 – 7 June 2023 Get access Michael Autrey Michael Autrey Romney, West Virginia, USA mvksautrey@gmail.com Search for other works by this author on: Oxford Academic Google Scholar Essays in Criticism, Volume 73, Issue 3, July 2023, Pages 265–274, https://doi.org/10.1093/escrit/cgad026 Published: 20 September 2023","PeriodicalId":43350,"journal":{"name":"ESSAYS IN CRITICISM","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135806153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"文学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal Article A Romance with Words Get access A Greeting of the Spirit: Selected Poetry of John Keats with Commentaries. By Susan J. Wolfson. The Belknap Press of Harvard University Press, 2022; $35. Adrian Grafe Adrian Grafe Université d’Artois, Arras, France grafe.adrian@wanadoo.fr Search for other works by this author on: Oxford Academic Google Scholar Essays in Criticism, Volume 73, Issue 3, July 2023, Pages 363–367, https://doi.org/10.1093/escrit/cgad032 Published: 20 September 2023
{"title":"A Romance with Words","authors":"Adrian Grafe","doi":"10.1093/escrit/cgad032","DOIUrl":"https://doi.org/10.1093/escrit/cgad032","url":null,"abstract":"Journal Article A Romance with Words Get access A Greeting of the Spirit: Selected Poetry of John Keats with Commentaries. By Susan J. Wolfson. The Belknap Press of Harvard University Press, 2022; $35. Adrian Grafe Adrian Grafe Université d’Artois, Arras, France grafe.adrian@wanadoo.fr Search for other works by this author on: Oxford Academic Google Scholar Essays in Criticism, Volume 73, Issue 3, July 2023, Pages 363–367, https://doi.org/10.1093/escrit/cgad032 Published: 20 September 2023","PeriodicalId":43350,"journal":{"name":"ESSAYS IN CRITICISM","volume":"124 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135806151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"文学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal Article Charlotte Brontë’s Shirley and the ‘Panoramic’ Novel Get access Nicholas Shrimpton Nicholas Shrimpton Lady Margaret Hall, Oxford, UK nicholas.shrimpton@lmh.ox.ac.uk Search for other works by this author on: Oxford Academic Google Scholar Essays in Criticism, Volume 73, Issue 3, July 2023, Pages 320–343, https://doi.org/10.1093/escrit/cgad030 Published: 20 September 2023
{"title":"Charlotte Brontë’s <i>Shirley</i> and the ‘Panoramic’ Novel","authors":"Nicholas Shrimpton","doi":"10.1093/escrit/cgad030","DOIUrl":"https://doi.org/10.1093/escrit/cgad030","url":null,"abstract":"Journal Article Charlotte Brontë’s Shirley and the ‘Panoramic’ Novel Get access Nicholas Shrimpton Nicholas Shrimpton Lady Margaret Hall, Oxford, UK nicholas.shrimpton@lmh.ox.ac.uk Search for other works by this author on: Oxford Academic Google Scholar Essays in Criticism, Volume 73, Issue 3, July 2023, Pages 320–343, https://doi.org/10.1093/escrit/cgad030 Published: 20 September 2023","PeriodicalId":43350,"journal":{"name":"ESSAYS IN CRITICISM","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135806152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"文学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal Article Interpretation and Authority in Marvell’s ‘The Nymph Complaining’ Get access Dominic Gavin Dominic Gavin University of York, UK domgavin@gmail.com Search for other works by this author on: Oxford Academic Google Scholar Essays in Criticism, Volume 73, Issue 3, July 2023, Pages 297–319, https://doi.org/10.1093/escrit/cgad028 Published: 20 September 2023
{"title":"Interpretation and Authority in Marvell’s ‘The Nymph Complaining’","authors":"Dominic Gavin","doi":"10.1093/escrit/cgad028","DOIUrl":"https://doi.org/10.1093/escrit/cgad028","url":null,"abstract":"Journal Article Interpretation and Authority in Marvell’s ‘The Nymph Complaining’ Get access Dominic Gavin Dominic Gavin University of York, UK domgavin@gmail.com Search for other works by this author on: Oxford Academic Google Scholar Essays in Criticism, Volume 73, Issue 3, July 2023, Pages 297–319, https://doi.org/10.1093/escrit/cgad028 Published: 20 September 2023","PeriodicalId":43350,"journal":{"name":"ESSAYS IN CRITICISM","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135806150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"文学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal Article Silence in Shakespeare’s Comedies Get access David M Bergeron David M Bergeron University of Kansas, USA bergeron@ku.edu Search for other works by this author on: Oxford Academic Google Scholar Essays in Criticism, Volume 73, Issue 3, July 2023, Pages 275–296, https://doi.org/10.1093/escrit/cgad027 Published: 20 September 2023
期刊文章莎士比亚喜剧中的沉默获取访问David M Bergeron David M Bergeron堪萨斯大学，美国bergeron@ku.edu搜索作者的其他作品:牛津学术谷歌学者评论论文，第73卷，第3期，2023年7月，275-296页，https://doi.org/10.1093/escrit/cgad027出版:2023年9月20日
{"title":"Silence in Shakespeare’s Comedies","authors":"David M Bergeron","doi":"10.1093/escrit/cgad027","DOIUrl":"https://doi.org/10.1093/escrit/cgad027","url":null,"abstract":"Journal Article Silence in Shakespeare’s Comedies Get access David M Bergeron David M Bergeron University of Kansas, USA bergeron@ku.edu Search for other works by this author on: Oxford Academic Google Scholar Essays in Criticism, Volume 73, Issue 3, July 2023, Pages 275–296, https://doi.org/10.1093/escrit/cgad027 Published: 20 September 2023","PeriodicalId":43350,"journal":{"name":"ESSAYS IN CRITICISM","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135806154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"文学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal Article Haunting the Revolution Get access The French Revolution: A History in Three Volumes. By Thomas Carlyle. Edited by Mark Cummings and David R. Sorensen. Text edited by Mark Engel and Brent E. Kinser. Vol. I, The Bastille; Vol. II, The Constitution; Vol. III, The Guillotine. Oxford University Press, 2020; £385. Mark Philp Mark Philp University of Warwick, UK mark.philp@warwick.ac.uk https://orcid.org/0000-0003-0496-2373 Search for other works by this author on: Oxford Academic Google Scholar Essays in Criticism, Volume 73, Issue 2, April 2023, Pages 255–263, https://doi.org/10.1093/escrit/cgad018 Published: 15 July 2023
期刊文章萦绕革命获得访问法国大革命:三卷的历史。托马斯·卡莱尔著。马克·卡明斯和大卫·r·索伦森编辑。文本编辑马克·恩格尔和布伦特E.金瑟。第一卷，巴士底狱;第二卷，宪法;第三卷，断头台牛津大学出版社，2020;£385。Mark Philp Mark Philp英国华威大学mark.philp@warwick.ac.uk https://orcid.org/0000-0003-0496-2373搜索作者的其他作品:牛津学术谷歌学者评论论文，第73卷，第2期，2023年4月，255-263页，https://doi.org/10.1093/escrit/cgad018出版日期:2023年7月15日
{"title":"Haunting the Revolution","authors":"Mark Philp","doi":"10.1093/escrit/cgad018","DOIUrl":"https://doi.org/10.1093/escrit/cgad018","url":null,"abstract":"Journal Article Haunting the Revolution Get access The French Revolution: A History in Three Volumes. By Thomas Carlyle. Edited by Mark Cummings and David R. Sorensen. Text edited by Mark Engel and Brent E. Kinser. Vol. I, The Bastille; Vol. II, The Constitution; Vol. III, The Guillotine. Oxford University Press, 2020; £385. Mark Philp Mark Philp University of Warwick, UK mark.philp@warwick.ac.uk https://orcid.org/0000-0003-0496-2373 Search for other works by this author on: Oxford Academic Google Scholar Essays in Criticism, Volume 73, Issue 2, April 2023, Pages 255–263, https://doi.org/10.1093/escrit/cgad018 Published: 15 July 2023","PeriodicalId":43350,"journal":{"name":"ESSAYS IN CRITICISM","volume":"329 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135722855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"文学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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