Is Head and Neck Free Flap Reconstruction Feasible in Jehovah's Witness Patients?
Journal
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
ISSN: 1531-5053
Titre abrégé: J Oral Maxillofac Surg
Pays: United States
ID NLM: 8206428
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
received:
14
01
2023
revised:
07
08
2023
accepted:
08
08
2023
medline:
6
11
2023
pubmed:
29
8
2023
entrez:
28
8
2023
Statut:
ppublish
Résumé
Jehovah's Witnesses (JW) population are members of a religious group that refuses blood transfusion. This presents a dilemma for surgical teams when performing major surgical procedures on these patients. This study aimed to assess the safety and feasibility of undergoing microvascular free flaps for maxillofacial reconstruction in JW patients and whether the type of underlying pathology impacts outcomes. This was a multi-institutional retrospective cohort study. The sample consisted of all JW patients who have undergone microvascular free tissue transfer for maxillofacial pathology between January 2016 and January 2021. The primary predictor variable was the underlying pathology for which patients underwent head and neck free flap reconstruction; this was benign versus malignant disease. The primary outcome variables were safety, defined as discharge from the hospital with no mortality, and feasibility defined as successful free flap reconstruction. Other variables included age, race, sex, length of surgery, length of hospital stay, and intraoperative use of vasopressors. Data analysis was performed utilizing t-tests for means and χ A total of 12 participants from 7 participating sites met the inclusion criteria. There were 9 males and 3 females with a mean age of 58.3 ± 8.3 years. There were no deaths in this cohort and all patients were discharged from the hospital. All 12 free flap reconstructions were successful with no incidents of free flap loss; none of the patients received any blood transfusions or any other blood products. Subgroup analysis showed that patients treated for malignant disease versus benign disease had longer operations (11.2 ± 2.9 vs 6.3 ± 0.2 hours, P < .01) and a longer hospital length of stay (11.8 ± 4.9 vs 5.3 ± 0.5 days, P = .04). Our series supports the safety and feasibility of maxillofacial free flap reconstruction in this challenging subset of patients. Microvascular reconstructive surgeries for malignant diseases often result in longer operative times and hospital stays.
Sections du résumé
BACKGROUND
Jehovah's Witnesses (JW) population are members of a religious group that refuses blood transfusion. This presents a dilemma for surgical teams when performing major surgical procedures on these patients.
PURPOSE
This study aimed to assess the safety and feasibility of undergoing microvascular free flaps for maxillofacial reconstruction in JW patients and whether the type of underlying pathology impacts outcomes.
STUDY DESIGN, SETTING, AND SAMPLE
This was a multi-institutional retrospective cohort study. The sample consisted of all JW patients who have undergone microvascular free tissue transfer for maxillofacial pathology between January 2016 and January 2021.
PREDICTOR VARIABLE
The primary predictor variable was the underlying pathology for which patients underwent head and neck free flap reconstruction; this was benign versus malignant disease.
MAIN OUTCOME VARIABLES
The primary outcome variables were safety, defined as discharge from the hospital with no mortality, and feasibility defined as successful free flap reconstruction.
COVARIATES
Other variables included age, race, sex, length of surgery, length of hospital stay, and intraoperative use of vasopressors.
ANALYSIS
Data analysis was performed utilizing t-tests for means and χ
RESULTS
A total of 12 participants from 7 participating sites met the inclusion criteria. There were 9 males and 3 females with a mean age of 58.3 ± 8.3 years. There were no deaths in this cohort and all patients were discharged from the hospital. All 12 free flap reconstructions were successful with no incidents of free flap loss; none of the patients received any blood transfusions or any other blood products. Subgroup analysis showed that patients treated for malignant disease versus benign disease had longer operations (11.2 ± 2.9 vs 6.3 ± 0.2 hours, P < .01) and a longer hospital length of stay (11.8 ± 4.9 vs 5.3 ± 0.5 days, P = .04).
CONCLUSION AND RELEVANCE
Our series supports the safety and feasibility of maxillofacial free flap reconstruction in this challenging subset of patients. Microvascular reconstructive surgeries for malignant diseases often result in longer operative times and hospital stays.
Identifiants
pubmed: 37640237
pii: S0278-2391(23)00802-9
doi: 10.1016/j.joms.2023.08.006
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1435-1442Informations de copyright
Copyright © 2023 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.