Objective
Aging is associated with structural and functional cardiovascular changes that may
affect microvascular free flap perfusion, which is a prerequisite for flap viability
and flap success. This study is aimed to investigate the impact of age on flap perfusion.
Study Design
Intraoperative and postoperative flap perfusion of 348 patients who underwent successful
reconstruction with a radial free forearm flap (RFFF), anterolateral thigh flap (ALTF),
or fibular free flap (FFF) was retrospectively analyzed and compared between older
(>70 years) and younger patients (≤70 years) using the Mann-Whitney test and linear
regression models.
Results
Intraoperative flap blood flow and hemoglobin concentration (55.5 arbitrary units
[AU] vs 69.3 AU, P = .004; 42.5 AU vs 47.3 AU, P = .016, respectively) were reduced in ALTFs in older patients compared with younger
patients. These 2 differences did not persist in multivariable testing (P = .097 and P = .323, respectively). No other differences were observed between the older and younger
patients in terms of intraoperative and postoperative flap blood flow, hemoglobin
concentration, and hemoglobin oxygen saturation in RFFFs, ALTFs, and FFFs (all P > .05).
Conclusions
Age has no impact on microvascular free flap perfusion in RFFFs, ALTFs, and FFFs.
This could contribute to the observed equal success of free flaps in older patients.
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Article info
Publication history
Published online: May 25, 2022
Accepted:
May 20,
2022
Received in revised form:
May 15,
2022
Received:
April 15,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
