• Jonathan R Clark, Stuart A McCluskey, Francis Hall, Joan Lipa, Peter Neligan, Dale Brown, Jonathan Irish, Patrick Gullane, and Ralph Gilbert.
• Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Hospital, Toronto, Ontario, Canada. jcjc@tpg.com
• Head Neck. 2007 Dec 1; 29 (12): 1090-101.

BackgroundFree flap reconstruction of head and neck cancer defects is complex with many factors that influence perioperative complications. The aim was to determine if there was an association between perioperative variables and postoperative outcome.MethodsWe evaluated 185 patients undergoing free flap reconstruction following ablation of head and neck cancer between 1999 and 2001. Demographic, laboratory, surgical and anesthetic variables were analyzed using univariate and multivariable techniques.ResultsNinety-eight patients (53%) developed complications, of which 74 were considered major, giving a major morbidity rate of 40%. Predictors of major complications were increasing patient age, ASA class, and smoking. Predictors of medical complications were ASA class, smoking, age and crystalloid replacement. Predictors of surgical complications were tracheostomy, preoperative hemoglobin, and preoperative radiotherapy.ConclusionPatient age, comorbidity, smoking, preoperative hemoglobin, and perioperative fluid management are potential predictors of postoperative complications following free flap reconstruction for cancer of the head and neck.

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