Immediate Teeth in Fibulas Versus Standard Fibula Free Flap: A Comparison of Donor Surgical Site Infections.


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:
04 Jan 2024
Historique:
received: 26 10 2023
revised: 14 12 2023
accepted: 02 01 2024
medline: 26 1 2024
pubmed: 26 1 2024
entrez: 25 1 2024
Statut: aheadofprint

Résumé

Immediate placement of dental implants with dental restoration at the leg donor site requires implant components and prosthetic materials that are not packaged sterile. This study aimed to determine if there was a difference in donor surgical site infection between patients that received a fibula free flap with dental implants and immediate teeth (ITFFF: immediate teeth fibula free flap) before flap transfer to the defect site when compared to standard fibula free flaps (SFFFs) without dental implant placement. A retrospective cohort study was designed and implemented. The study population was composed of patients who underwent free fibula flap transfer for the treatment of benign or malignant conditions of the head and neck from 2015 to 2022. Patients who received immediate dental implants without teeth were excluded, since those implants are sterile and buried under soft tissue. The surgical treatment with either ITFFF or SFFF was treated as the primary predictor variable. The primary outcome variable was postoperative donor surgical site infection. There were 12 covariate variables including age, sex, diabetes diagnosis, immunosuppression/prior chemotherapy treatment, body mass index, smoking status, pack year history, pathology treated, technique for fibula donor site closure, skin paddle harvest, skin paddle area (cm For the effect of the covariates on the primary predictor variable, χ There were 37 patients in the ITFFF group and 47 in the SFFF group. The donor site infection rate for the entire study population was 2.38%. In the ITFFF group, there was 1 donor surgical site infection (2.70%), and in the SFFF group there was also 1 donor surgical site infection (2.13%). There was no significant difference in donor surgical site infection between the groups (P = .86). This study found no difference in donor surgical site infection rates between patients who received ITFFF versus SFFF. The overall donor surgical site infection rate following fibula free flap is low.

Sections du résumé

BACKGROUND BACKGROUND
Immediate placement of dental implants with dental restoration at the leg donor site requires implant components and prosthetic materials that are not packaged sterile.
PURPOSE OBJECTIVE
This study aimed to determine if there was a difference in donor surgical site infection between patients that received a fibula free flap with dental implants and immediate teeth (ITFFF: immediate teeth fibula free flap) before flap transfer to the defect site when compared to standard fibula free flaps (SFFFs) without dental implant placement.
STUDY DESIGN, SETTING, SAMPLE UNASSIGNED
A retrospective cohort study was designed and implemented. The study population was composed of patients who underwent free fibula flap transfer for the treatment of benign or malignant conditions of the head and neck from 2015 to 2022. Patients who received immediate dental implants without teeth were excluded, since those implants are sterile and buried under soft tissue.
PREDICTOR VARIABLE METHODS
The surgical treatment with either ITFFF or SFFF was treated as the primary predictor variable.
MAIN OUTCOME VARIABLE METHODS
The primary outcome variable was postoperative donor surgical site infection.
COVARIATES UNASSIGNED
There were 12 covariate variables including age, sex, diabetes diagnosis, immunosuppression/prior chemotherapy treatment, body mass index, smoking status, pack year history, pathology treated, technique for fibula donor site closure, skin paddle harvest, skin paddle area (cm
ANALYSES METHODS
For the effect of the covariates on the primary predictor variable, χ
RESULTS RESULTS
There were 37 patients in the ITFFF group and 47 in the SFFF group. The donor site infection rate for the entire study population was 2.38%. In the ITFFF group, there was 1 donor surgical site infection (2.70%), and in the SFFF group there was also 1 donor surgical site infection (2.13%). There was no significant difference in donor surgical site infection between the groups (P = .86).
CONCLUSION AND RELEVANCE CONCLUSIONS
This study found no difference in donor surgical site infection rates between patients who received ITFFF versus SFFF. The overall donor surgical site infection rate following fibula free flap is low.

Identifiants

pubmed: 38272445
pii: S0278-2391(24)00002-8
doi: 10.1016/j.joms.2024.01.002
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Timothy W Neal (TW)

Resident, Department of Surgery, Division of Oral and Maxillofacial Surgery, UT Southwestern/Parkland Memorial Hospital. Electronic address: Timothy.Neal@UTSouthwestern.edu.

Fayette C Williams (FC)

Director, Maxillofacial Oncology and Reconstructive Surgery, John Peter Smith Hospital Health Network, Fort Worth, TX.

Jonathan Jelmini (J)

Fellow, Maxillofacial Oncology and Reconstructive Surgery, John Peter Smith Health Network, Fort Worth, TX.

Wyatt Spresser (W)

Resident, Department of Surgery, Division of Oral and Maxillofacial Surgery, UT Southwestern/Parkland Memorial Hospital.

David Schwitzer (D)

Fellow, Maxillofacial Oncology and Reconstructive Surgery, John Peter Smith Health Network, Fort Worth, TX.

Roderick Y Kim (RY)

Vice Director, Maxillofacial Oncology and Reconstructive Surgery, John Peter Smith Hospital Health Network, Fort Worth, TX.

Classifications MeSH