Free Flaps for Skin and Soft Tissue Reconstruction in the Elderly Patient: Indication or Contraindication
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient Data/Group | YOUNG (4–59) | OLD (≥60) | ALL |
---|---|---|---|
Number (n) | 51 | 59 | 110 |
Female | 25 (49.0%) | 28 (47.5%) | 53 (48.2%) |
Age, mean (±SD) | 43.9 (±14.9) | 72.7 (±7.7) | 59.3 (±18.5) |
Smoker n (%) | 21 (41.2%) | 12 (20.7%) * 1 | 33 (30.3 %) * 1 |
BMI Group | |||
0 (BMI 15 to < 30) | 43 (84.3%) | 39 (68.4%) * 2 | 82 (75.9 %) * 2 |
1 (BMI 30 to < 40) | 7 (13.7%) | 16 (28.1%) * 2 | 23 (21.3 %) * 2 |
2 (BMI 40 and more) | 1 (2.0%) | 2 (3.5%) * 2 | 3 (2.8 %) * 2 |
ASA-Classification (1 to 6) | |||
1—normal | 8 (16.0%) * 1 | 6 (10.3%) * 1 | 14 (13.0 %) * 2 |
2—mild general disease | 31 (62.0%) * 1 | 26 (44.8%) * 1 | 57 (52.8 %) * 2 |
3 + 4—severe general disease | 11 (22.0%) * 1 | 26 (44.8%) * 1 | 37 (34.3 %) * 2 |
Patient Data/Group | YOUNG (4–59) | OLD (≥60) | ALL |
---|---|---|---|
Tumor | 16 (31.4%) | 16 (27.1%) | 32 (29.1%) |
Previous cardiological disease | 14 (27.5%) | 46 (78.0%) | 60 (54.6%) |
Diabetes mellitus | 4 (7.8%) | 18 (30.5%) | 22 (20.0%) |
Thyroid disease | 3 (5.9%) | 14 (23.7%) | 17 (15.5%) |
Lung disease | 6 (11.8%) | 12 (20.3%) | 18 (16.4%) |
Liver disease | 1 (2.0%) | 3 (5.1%) | 4 (3.6%) |
Renal disease | 3 (5.9%) | 10 (17.0%) | 13 (11.8%) |
Neurological pre-existing disease | 6 (11.2%) | 14 (23.7%) | 20 (18.2%) |
Vascular disease | 5 (9.8%) | 15 (25.4%) | 20 (18.2%) |
Rheumatoid pre-existing disease | 0 (0.0%) | 4 (6.8%) | 4 (3.6%) |
Alcohol and drug abuse | 3 (5.9%) | 3 (5.1%) | 6 (10.4%) |
Chemotherapy | 3 (5.9%) | 2 (3.4%) | 5 (8.8%) |
Flap Details/Group | YOUNG (4–59) | OLD (≥60) | ALL |
---|---|---|---|
Quantity | 63 | 66 | 129 |
Flap type | |||
Anterior lateral thigh | 27 (42.9%) | 33 (50.0%) | 60 (46.5%) |
M. latissimus dorsi | 13 (20.6%) | 24 (36.4%) | 37 (28.7%) |
Other | 23 (36.5%) | 9 (13.6%) | 32 (24.8%) |
Recipient region | |||
Head/neck/trunk | 19 (30.2%) | 12 (18.2%) | 31 (24.0%) |
Upper extremities | 10 (15.9%) | 3 (4.5%) | 13 (10.1%) |
Lower extremities | 34 (54.0%) | 51 (77.3%) | 85 (65.9%) |
Reasons for free flap | |||
Fracture | 18 (29.5%) * 2 | 17 (25.8%) | 35 (27.6%) * 2 |
Tumor | 19 (31.1%) * 2 | 14 (21.2%) | 33 (26.0%) * 2 |
Infection | 11 (18.0%) * 2 | 20 (30.3%) | 31 (24.4%) * 2 |
Other | 13 (21.3%) * 2 | 16 (24.2%) | 29 (22.8%) * 2 |
Radiotherapy of the recipient region | 6 (9.5%) | 5 (7.6%) | 11 (8.5%) |
Additional skin graft | 22 (34.9%) | 25 (38.5%) * 1 | 47 (36.7%) * 1 |
Intraoperative revision | 3 (4.8%) * 1 | 7 (10.6%) | 10 (7.8%) * 1 |
Total flap loss | 7 (11.1%) | 7 (10.6%) | 14 (10.9%) |
Primary surgeries/group | |||
Number | 59 | 65 | 124 |
Anticoagulant administration | 33 (57.9%) * 2 | 39 (62.9%) * 3 | 72 (60.5%) * 5 |
Surgery duration in minutes, mean (±SD) | 388.3 (122.5) * 1 | 385.2 (147.7) | 386.7 (135.6) * 1 |
Number of erythrocyte concentrates given, mean (±SD) | 0.3 (±0.9) | 0.8 (±1.9) | 0.6 (±1.5) |
Hospital stay data/group | |||
Number of primary flap surgeries | 59 (39.6%) | 65 (38.0%) | 124 (38.8%) |
Number of flap revisions | 8 (5.4%) | 14 (8.2%) | 22 (6.9%) |
Stays with lethal end | 2 (3.9%) | 1 (1.7%) | 3 (2.7%) |
Length of stay in days, mean (±SD) ** | 30.0 (±21.8) | 33.6 (±20.0) | 32.0 (±20.8) |
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Sorg, H.; Sorg, C.G.G.; Tilkorn, D.J.; Thönnes, S.; Karimo, R.; Hauser, J. Free Flaps for Skin and Soft Tissue Reconstruction in the Elderly Patient: Indication or Contraindication. Med. Sci. 2023, 11, 12. https://doi.org/10.3390/medsci11010012
Sorg H, Sorg CGG, Tilkorn DJ, Thönnes S, Karimo R, Hauser J. Free Flaps for Skin and Soft Tissue Reconstruction in the Elderly Patient: Indication or Contraindication. Medical Sciences. 2023; 11(1):12. https://doi.org/10.3390/medsci11010012
Chicago/Turabian StyleSorg, Heiko, Christian G. G. Sorg, Daniel J. Tilkorn, Simon Thönnes, Rees Karimo, and Jörg Hauser. 2023. "Free Flaps for Skin and Soft Tissue Reconstruction in the Elderly Patient: Indication or Contraindication" Medical Sciences 11, no. 1: 12. https://doi.org/10.3390/medsci11010012
APA StyleSorg, H., Sorg, C. G. G., Tilkorn, D. J., Thönnes, S., Karimo, R., & Hauser, J. (2023). Free Flaps for Skin and Soft Tissue Reconstruction in the Elderly Patient: Indication or Contraindication. Medical Sciences, 11(1), 12. https://doi.org/10.3390/medsci11010012