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Volume 14
Issue 11
10.3390/jcm14113679
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Perioperative Nutritional and Metabolic Factors Affecting Surgical Outcomes in Head and Neck Cancer Free Flap Reconstruction: A Comprehensive Review

by
Andrzej Jaxa-Kwiatkowski
1,*,
Marek Jaxa-Kwiatkowski
2,
Katarzyna Jaxa-Kwiatkowska
3,
Hanna Gerber
1,
Marcin Kubiak
1 and
Lidia Łysenko
4
1
Clinical Department of Maxillofacial Surgery, Faculty of Dentistry, Wroclaw Medical University, 50-367 Wrocław, Poland
2
Department of Maxillofacial Surgery, Heliodor Swiecicki Clinical Hospital in Poznan, 60-355 Poznan, Poland
3
Division of Anatomy Part of the Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland
4
Department and Clinic of Anaesthesiology and Intensive Care, Faculty of Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(11), 3679; https://doi.org/10.3390/jcm14113679
Submission received: 19 April 2025 / Revised: 16 May 2025 / Accepted: 21 May 2025 / Published: 23 May 2025
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)
Versions Notes

Abstract

Head and neck cancer (HNC) remains a major global health issue. It is closely linked to smoking, alcohol use, and HPV infection. Nutritional and metabolic factors significantly influence surgical outcomes in these patients, especially when undergoing extensive resections and microsurgical free flap reconstruction. This comprehensive review aims to evaluate how perioperative nutritional status—particularly body mass index (BMI), serum albumin and prealbumin levels, and enteral vs. oral feeding strategies—affects complication rates, wound healing, surgical duration, and overall recovery. Poor nutritional status is associated with increased complication rates, prolonged surgery, impaired wound healing, and higher perioperative mortality. Both high and low BMI negatively impact surgical outcomes. Obesity is linked to protracted surgery and increased blood loss, while underweight patients have higher perioperative mortality. Optimizing perioperative nutrition is important for improving surgical outcomes in HNC patients. A multidisciplinary approach is necessary to tailor nutritional support and enhance recovery. Further research should focus on long-term weight management strategies and identifying biomarkers predictive of surgical success.
Keywords: BMI; head and neck cancer; reconstructive surgery; oncology; nutrition BMI; head and neck cancer; reconstructive surgery; oncology; nutrition

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MDPI and ACS Style

Jaxa-Kwiatkowski, A.; Jaxa-Kwiatkowski, M.; Jaxa-Kwiatkowska, K.; Gerber, H.; Kubiak, M.; Łysenko, L. Perioperative Nutritional and Metabolic Factors Affecting Surgical Outcomes in Head and Neck Cancer Free Flap Reconstruction: A Comprehensive Review. J. Clin. Med. 2025, 14, 3679. https://doi.org/10.3390/jcm14113679

AMA Style

Jaxa-Kwiatkowski A, Jaxa-Kwiatkowski M, Jaxa-Kwiatkowska K, Gerber H, Kubiak M, Łysenko L. Perioperative Nutritional and Metabolic Factors Affecting Surgical Outcomes in Head and Neck Cancer Free Flap Reconstruction: A Comprehensive Review. Journal of Clinical Medicine. 2025; 14(11):3679. https://doi.org/10.3390/jcm14113679

Chicago/Turabian Style

Jaxa-Kwiatkowski, Andrzej, Marek Jaxa-Kwiatkowski, Katarzyna Jaxa-Kwiatkowska, Hanna Gerber, Marcin Kubiak, and Lidia Łysenko. 2025. "Perioperative Nutritional and Metabolic Factors Affecting Surgical Outcomes in Head and Neck Cancer Free Flap Reconstruction: A Comprehensive Review" Journal of Clinical Medicine 14, no. 11: 3679. https://doi.org/10.3390/jcm14113679

APA Style

Jaxa-Kwiatkowski, A., Jaxa-Kwiatkowski, M., Jaxa-Kwiatkowska, K., Gerber, H., Kubiak, M., & Łysenko, L. (2025). Perioperative Nutritional and Metabolic Factors Affecting Surgical Outcomes in Head and Neck Cancer Free Flap Reconstruction: A Comprehensive Review. Journal of Clinical Medicine, 14(11), 3679. https://doi.org/10.3390/jcm14113679

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