FACTORS CONTRIBUTING TO THE RISK OF SURGICAL SITE INFECTION AND SEPSIS FOLLOWING RECONSTRUCTIVE FLAP SURGERY
DOI:
https://doi.org/10.61841/j6pnqa11Keywords:
Reconstructive flap surgery, sepsis, surgical site infectionAbstract
Introduction: Reconstructive flap surgery, vital for addressing defects in diverse body regions, is employed in post-cancer and traumatic wound reconstruction, yielding favorable outcomes. While minor complications are well-documented, systemic complications, particularly sepsis, remain underexplored. This systematic review fills the gap by investigating sepsis incidence and associated risk factors in reconstructive flap surgery, aiming to enhance understanding, prevent complications, and improve patient care.
Method: The researchers in this study followed the 2020 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to ensure that their work met the required standards. This was done to ensure the precision and reliability of the conclusions derived from the research.
Result: Our search produced 14 results. After looking at the titles and summaries, we found several papers that fit our criteria. At first, we excluded few articles because they were written in review and case report style. But after reading the full papers carefully, we included five papers in our final analysis. These papers included retrospective review study and retrospective studies.
Conclusion: Postoperative sepsis and surgical site infections (SSIs) are significant challenges in reconstructive flap surgery, with a 2.1% sepsis incidence and identified risk factors including comorbidities, BMI, and ASA Score. Sepsis elevates 30-day mortality risk almost fivefold, emphasizing the need for preventive measures. Our study underscores the impact equivalence of SSIs and Major Postoperative Infections (MPIs) and recommends a 72-hour antibiotic prophylaxis duration in head and neck free flap surgery. Notably, preoperative recipient site infection in lower extremity tissue transfer influences graft outcomes, and longer operating time consistently predicts SSIs, necessitating strategic planning and comprehensive comorbidity management. Prospective studies are crucial for refining predictors and optimizing patient care in reconstructive flap surgery.
References
Bajaj AK, Chevray PM, Chang DW. Comparison of donorsite complications and functional outcomes in free musclesparing TRAM flap and free DIEP flap breast reconstruction. Plast Reconstr Surg. 2006;117:737.
Hidalgo DA, Pusic AL. Free-flap mandibular reconstruction: a 10-year follow-up study. Plast Reconstr Surg. 2002;110: 438.
Cannady SB, Hatten KM, Bur AM, et al. Use of free tissue transfer in head and neck cancer surgery and risk of overall and serious complication(s): an American College of Surgeons-National Surgical Quality Improvement Project analysis of free tissue transfer to the head and neck. Head Neck. 2017;39:702–707.
Carniol ET, Marchiano E, Brady JS, et al. Head and neck microvascular free flap reconstruction: an analysis of unplanned readmissions. Laryngoscope. 2017;127:325–330.
Yarlagadda BB, Deschler DG, Rich DL, et al. Head and neck free flap surgical site infections in the era of the Surgical Care Improvement Project. Head Neck. 2016;38:E392–E398.
Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315:801–810.
Blair LJ, Huntington CR, Cox TC, et al. Risk factors for postoperative sepsis in laparoscopic gastric bypass. Surg Endosc. 2016;30:1287–1293
Sebastian Sparenberg, Louise L. Blankensteijn, Ahmed M. Ibrahim, Abbas Peymani & Samuel J. Lin (2019): Risk factors associated with the development of sepsis after reconstructive flap surgery, Journal of Plastic Surgery and Hand Surgery, DOI: 10.1080/2000656X.2019.1626738
Gugliotta Y, Rubattino S, Fasolis M, Ramieri G, Copelli C. Postoperative infections associated with microvascular free flaps in head and neck reconstruction: Analysis of risk factors and results with a standardized prophylaxis protocol. J Plast Reconstr Aesthet Surg. 2023;87:61-68. doi:10.1016/j.bjps.2023.09.046
Gearing PF, Daly JF, Tang NSJ, Singh K, Ramakrishnan A. Risk factors for surgical site infection in free-flap reconstructive surgery for head and neck cancer: Retrospective Australian cohort study. Head Neck. 2021;43(11):3417-3428. doi:10.1002/hed.26837
Barrette, Louis-Xavier & Fowler, Cody & Henderson, Stacy & Kozak, Geoffrey & Stranix, John & Broach, Robyn & Fischer, John & Levin, Lawrence & Kovach, Stephen. (2021). Does preoperative wound infection impact outcomes of lower extremity salvage via microvascular free flap reconstruction? A cohort study. Orthoplastic Surgery. 6. 11-14. 10.1016/j.orthop.2021.09.001.
Hassan B, Abou Koura A, Makarem A, Abi Mosleh K, Dimassi H, Tamim H and Ibrahim A (2023) Predictors of surgical site infection following reconstructive flap surgery: A multiinstitutional analysis of 37,177 patients. Front. Surg. 10:1080143. doi: 10.3389/fsurg.2023.1080143
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Journal of Advanced Research in Medical and Health Science (ISSN 2208-2425)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Licensing
Ninety Nine Publication publishes articles under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This licensing allows for any use of the work, provided the original author(s) and source are credited, thereby facilitating the free exchange and use of research for the advancement of knowledge.
Detailed Licensing Terms
Attribution (BY): Users must give appropriate credit, provide a link to the license, and indicate if changes were made. Users may do so in any reasonable manner, but not in any way that suggests the licensor endorses them or their use.
No Additional Restrictions: Users may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
