Experience of a Tertiary Hospital with Coverage Failures and their Management with Free Flaps and Rotational Flaps
DOI:
https://doi.org/10.21270/archi.v12i1.6052Keywords:
Surgical Flaps, Perforator Flap, Myocutaneos FlapAbstract
Introduction: The coverage of skin defects with free and rotational flaps is a well-established management, mainly with increased technical capacity and instruments. Several flaps were described, and despite efforts to reduce technical errors, complication rates are still high. These complications depend on factors inherent to the patient, surgery, and postoperative management. This study proposes to elucidate the population submitted to coverage failure treatment with free, rotational, and advancement flaps, as well as the complication rate and need for a new approach. Methods: Retrospective study from the medical records of patients undergoing surgical treatment of skin coverage failure with free and rotational flaps from January 2015 to December 2021 in a tertiary hospital. Results: The global reoperation rate was 68.8%, 85.7% in free flaps, and 57.8% in rotation flaps (p<0.001), with a statistical difference for the length of coverage area (p=0.001) and surgical time (p<0.001), with no difference in the size of the gap (p=0.458). The overall failure rate of the flaps was 16.9%, 23.8% in the free flaps, and 12.5% in the rotation flaps (p=0.032). Flap failure showed a statistical difference for the size of the gap (p=0.004), surgical time (p=0.040), and length of stay in days (p=0.015). Conclusion: flap failure and reoperation rates are consistent with the literature data. Multidisciplinary teams can control comorbidities so as not to influence the postoperative result.
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References
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