Abstract
Objective : To evaluate whether prolonged operative time is
negatively associated with post-operative complications and length of
stay in patients undergoing microvascular free flap reconstruction for
complex head and neck defects.
Methods : 342 consecutive patients undergoing microvascular
reconstruction for head and neck defects between 2017-2019 at a single
institution were evaluated. Operative outcomes and operative time were
compared whilst controlling for patient and treatment related factors.
Results : Mean operative time was 551 minutes and length of stay
was 16.2 days. An 11% increase in the risk of a post-operative
complication was observed for every additional hour of operative time
(OR 1.11, 95%CI 1.03 – 1.21, p=0.011) after adjusting for patient and
treatment factors. A cut-off of 9 hours yielded a 92% increase in
complications on either side of this (OR 1.92, 95%CI 1.18 – 3.13,
p=0.009). Increased operative time was also associated with increased
length of stay and return to theatres, but not medical complications.
Conclusion : Prolonged operative time is significantly
associated with increase surgical complications, length of stay and
return to theatres when performing microvascular reconstructive surgery
for head and neck defects.
Keywords : free flap, microsurgery, operative time, length of
hospital stay, complication rate, head and neck surgery