Clinical consequences of head and neck free-flap reconstructions in the DM population

Abstract Diabetes mellitus (DM) is a common comorbidity and risk factor for postoperative complications in head and neck (H&N) microsurgical reconstructions. Our study focused on the association between DM and individual complications regarding both surgical and medical aspects. A meta-analysis...

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Autores principales:	Ting-Han Chiu, Chung-Kan Tsao, Sheng-Nan Chang, Jou-Wei Lin, Juey-Jen Hwang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f8aa7c3229074b3c8456614c3166d726
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spelling	oai:doaj.org-article:f8aa7c3229074b3c8456614c3166d7262021-12-02T13:17:55ZClinical consequences of head and neck free-flap reconstructions in the DM population10.1038/s41598-021-85410-32045-2322https://doaj.org/article/f8aa7c3229074b3c8456614c3166d7262021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85410-3https://doaj.org/toc/2045-2322Abstract Diabetes mellitus (DM) is a common comorbidity and risk factor for postoperative complications in head and neck (H&N) microsurgical reconstructions. Our study focused on the association between DM and individual complications regarding both surgical and medical aspects. A meta-analysis of English-language articles comparing a series of complications between DM and non-DM H&N free-flap recipients was performed by comprehensive meta-analysis (CMA). Twenty-seven articles presented 14,233 H&N free-flap reconstructions, and a subset of 2329 analyses including diabetic cases was included for final analysis. Total postoperative (RR = 1.194, p < 0.001; OR = 1.506, p = 0.030) and surgical (RR = 1.550, p = 0.001; OR = 3.362, p < 0.001) complications were increased in DM subjects. Free-flap failure/necrosis (RR = 1.577, p = 0.001; OR = 1.999, p = 0.001) and surgical site infections (OR = 2.414, p < 0.001) were also increased in diabetic recipients. However, return to the operating room, dehiscence, fistulas, plate exposures, readmissions, and mortalities were not increased in DM patients. DM increased various complications in H&N free-flap reconstructions. Surgical indications should be cautiously evaluated, and aggressive treatments should be implemented for high-risk recipients.Ting-Han ChiuChung-Kan TsaoSheng-Nan ChangJou-Wei LinJuey-Jen HwangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ting-Han Chiu Chung-Kan Tsao Sheng-Nan Chang Jou-Wei Lin Juey-Jen Hwang Clinical consequences of head and neck free-flap reconstructions in the DM population
description	Abstract Diabetes mellitus (DM) is a common comorbidity and risk factor for postoperative complications in head and neck (H&N) microsurgical reconstructions. Our study focused on the association between DM and individual complications regarding both surgical and medical aspects. A meta-analysis of English-language articles comparing a series of complications between DM and non-DM H&N free-flap recipients was performed by comprehensive meta-analysis (CMA). Twenty-seven articles presented 14,233 H&N free-flap reconstructions, and a subset of 2329 analyses including diabetic cases was included for final analysis. Total postoperative (RR = 1.194, p < 0.001; OR = 1.506, p = 0.030) and surgical (RR = 1.550, p = 0.001; OR = 3.362, p < 0.001) complications were increased in DM subjects. Free-flap failure/necrosis (RR = 1.577, p = 0.001; OR = 1.999, p = 0.001) and surgical site infections (OR = 2.414, p < 0.001) were also increased in diabetic recipients. However, return to the operating room, dehiscence, fistulas, plate exposures, readmissions, and mortalities were not increased in DM patients. DM increased various complications in H&N free-flap reconstructions. Surgical indications should be cautiously evaluated, and aggressive treatments should be implemented for high-risk recipients.
format	article
author	Ting-Han Chiu Chung-Kan Tsao Sheng-Nan Chang Jou-Wei Lin Juey-Jen Hwang
author_facet	Ting-Han Chiu Chung-Kan Tsao Sheng-Nan Chang Jou-Wei Lin Juey-Jen Hwang
author_sort	Ting-Han Chiu
title	Clinical consequences of head and neck free-flap reconstructions in the DM population
title_short	Clinical consequences of head and neck free-flap reconstructions in the DM population
title_full	Clinical consequences of head and neck free-flap reconstructions in the DM population
title_fullStr	Clinical consequences of head and neck free-flap reconstructions in the DM population
title_full_unstemmed	Clinical consequences of head and neck free-flap reconstructions in the DM population
title_sort	clinical consequences of head and neck free-flap reconstructions in the dm population
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/f8aa7c3229074b3c8456614c3166d726
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Clinical consequences of head and neck free-flap reconstructions in the DM population

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