This article was presented at the 2007 AAO–HNSF Annual Meeting & OTO EXPO, Washington, DC, September 16-19, 2007.
Received 22 November 2008; received in revised form 14 October 2009; accepted 2 November 2009.
Abstract
Objective
To document the frequency of vasopressor use in free tissue transfer surgery and to compare the incidence of flap complications and flap survival in patients receiving or not receiving intraoperative vasopressors.
Study Design and Setting
Case series with chart review of free tissue transfers performed between 2004 and 2006 at a large-volume tertiary academic hospital.
Results
Of 241 free flaps, 169 had data available for analysis. Flap survival was 96.5 percent. The rate of other flap complications was 29 percent. A total of 139 (82%) patients received vasopressors intraoperatively. Of these, four (2.9%) flap failures and 40 (29%) complications occurred. In the 30 (18%) patients who did not receive vasopressors, two (6.7%) flap failures and nine (30%) complications occurred. The most common reasons for flap failure were arterial thrombus (n = 3) and thrombosis of the venous pedicle (n = 3).
Conclusion
Intraoperative vasopressors are used more frequently than previously realized but do not appear to increase overall flap failure and the incidence of complications. Intraoperative vasopressor use in free flap surgery may not be as harmful as previously feared.
aDepartment of Otolaryngology–Head and Neck Surgery, Oregon Health-Sciences University, Portland, OR
bDepartment of Anesthesiology, Oregon Health-Sciences University, Portland, OR
Corresponding author: Mark K. Wax, MD, Department of Otolaryngology–Head and Neck Surgery, Oregon Health-Sciences University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239
No sponsorships or competing interests have been disclosed for this article.
ABSTRACT