Externally Monitored Versus Conventional Buried Flaps in Laryngopharyngeal Reconstruction

Objectives To compare the surgical outcomes of externally monitored and conventional buried flaps with the goal of determining the usefulness of external monitoring of buried flaps. Methods In this case-control study with propensity score matching, 30 patients were evenly divided into externally mon...

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Autores principales:	Myung Jin Ban, Gina Na, Sungchul Ko, Joohyun Kim, Nam Hun Heo, Eun Chang Choi, Jae Hong Park, Won Shik Kim
Formato:	article
Lenguaje:	EN
Publicado:	Korean Society of Otorhinolaryngology-Head and Neck Surgery 2021
Materias:	laryngectomy pharyngectomy reconstructive surgical procedures free tissue flaps perioperative period buried flaps externally monitored buried flaps Medicine R Otorhinolaryngology RF1-547
Acceso en línea:	https://doaj.org/article/abc3a7a2f35b42129cbd646fbdd5f233
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spelling	oai:doaj.org-article:abc3a7a2f35b42129cbd646fbdd5f2332021-11-18T02:29:22ZExternally Monitored Versus Conventional Buried Flaps in Laryngopharyngeal Reconstruction1976-87102005-072010.21053/ceo.2020.00234https://doaj.org/article/abc3a7a2f35b42129cbd646fbdd5f2332021-11-01T00:00:00Zhttp://www.e-ceo.org/upload/pdf/ceo-2020-00234.pdfhttps://doaj.org/toc/1976-8710https://doaj.org/toc/2005-0720Objectives To compare the surgical outcomes of externally monitored and conventional buried flaps with the goal of determining the usefulness of external monitoring of buried flaps. Methods In this case-control study with propensity score matching, 30 patients were evenly divided into externally monitored buried flap and conventional buried flap groups. The total operative time for free flap reconstruction, the flap survival rate, the length of hospital stay, the initial time of a reliable visual assessment, complications, the final diet achieved, and the duration until diet initiation were compared between the groups. Results The mean operative time for reconstruction was 115 minutes (interquartile range, 85–150 minutes) and 142 minutes (interquartile range, 95–180 minutes) in the externally monitored and conventional groups, respectively (P= 0.245). The median length of hospital stay was 24 days (interquartile range, 18–30 days) and 27 days (interquartile range, 20–41 days) in the externally monitored and conventional groups, respectively (P=0.298). The median duration until diet initiation was 15 days (interquartile range, 15–21 days) and 18 days (interquartile range, 15–34 days) in the externally monitored and conventional groups, respectively (P=0.466). The final diet, initial time of a reliable visual assessment, and complications were comparable between the groups, but the external skin paddle provided an excellent visual assessment immediately postoperatively in all cases. Conclusion The outcomes were comparable between the groups, indicating that externalization of the cutaneous component of a buried flap may be a straightforward and useful technique for monitoring a buried anterolateral thigh free flap in laryngopharyngeal reconstructions. The salvage and false-positive rates of compromised flaps should be compared in large subject groups in future studies to prove that the use of an external skin paddle improves flap monitoring.Myung Jin BanGina NaSungchul KoJoohyun KimNam Hun HeoEun Chang ChoiJae Hong ParkWon Shik KimKorean Society of Otorhinolaryngology-Head and Neck Surgeryarticlelaryngectomypharyngectomyreconstructive surgical proceduresfree tissue flapsperioperative periodburied flapsexternally monitored buried flapsMedicineROtorhinolaryngologyRF1-547ENClinical and Experimental Otorhinolaryngology, Vol 14, Iss 4, Pp 407-413 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	laryngectomy pharyngectomy reconstructive surgical procedures free tissue flaps perioperative period buried flaps externally monitored buried flaps Medicine R Otorhinolaryngology RF1-547
spellingShingle	laryngectomy pharyngectomy reconstructive surgical procedures free tissue flaps perioperative period buried flaps externally monitored buried flaps Medicine R Otorhinolaryngology RF1-547 Myung Jin Ban Gina Na Sungchul Ko Joohyun Kim Nam Hun Heo Eun Chang Choi Jae Hong Park Won Shik Kim Externally Monitored Versus Conventional Buried Flaps in Laryngopharyngeal Reconstruction
description	Objectives To compare the surgical outcomes of externally monitored and conventional buried flaps with the goal of determining the usefulness of external monitoring of buried flaps. Methods In this case-control study with propensity score matching, 30 patients were evenly divided into externally monitored buried flap and conventional buried flap groups. The total operative time for free flap reconstruction, the flap survival rate, the length of hospital stay, the initial time of a reliable visual assessment, complications, the final diet achieved, and the duration until diet initiation were compared between the groups. Results The mean operative time for reconstruction was 115 minutes (interquartile range, 85–150 minutes) and 142 minutes (interquartile range, 95–180 minutes) in the externally monitored and conventional groups, respectively (P= 0.245). The median length of hospital stay was 24 days (interquartile range, 18–30 days) and 27 days (interquartile range, 20–41 days) in the externally monitored and conventional groups, respectively (P=0.298). The median duration until diet initiation was 15 days (interquartile range, 15–21 days) and 18 days (interquartile range, 15–34 days) in the externally monitored and conventional groups, respectively (P=0.466). The final diet, initial time of a reliable visual assessment, and complications were comparable between the groups, but the external skin paddle provided an excellent visual assessment immediately postoperatively in all cases. Conclusion The outcomes were comparable between the groups, indicating that externalization of the cutaneous component of a buried flap may be a straightforward and useful technique for monitoring a buried anterolateral thigh free flap in laryngopharyngeal reconstructions. The salvage and false-positive rates of compromised flaps should be compared in large subject groups in future studies to prove that the use of an external skin paddle improves flap monitoring.
format	article
author	Myung Jin Ban Gina Na Sungchul Ko Joohyun Kim Nam Hun Heo Eun Chang Choi Jae Hong Park Won Shik Kim
author_facet	Myung Jin Ban Gina Na Sungchul Ko Joohyun Kim Nam Hun Heo Eun Chang Choi Jae Hong Park Won Shik Kim
author_sort	Myung Jin Ban
title	Externally Monitored Versus Conventional Buried Flaps in Laryngopharyngeal Reconstruction
title_short	Externally Monitored Versus Conventional Buried Flaps in Laryngopharyngeal Reconstruction
title_full	Externally Monitored Versus Conventional Buried Flaps in Laryngopharyngeal Reconstruction
title_fullStr	Externally Monitored Versus Conventional Buried Flaps in Laryngopharyngeal Reconstruction
title_full_unstemmed	Externally Monitored Versus Conventional Buried Flaps in Laryngopharyngeal Reconstruction
title_sort	externally monitored versus conventional buried flaps in laryngopharyngeal reconstruction
publisher	Korean Society of Otorhinolaryngology-Head and Neck Surgery
publishDate	2021
url	https://doaj.org/article/abc3a7a2f35b42129cbd646fbdd5f233
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Externally Monitored Versus Conventional Buried Flaps in Laryngopharyngeal Reconstruction

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