Risk factors for flap dehiscence and/or necrosis following standard rotational flap in cranial vault osteomyelitis without intracranial involvement: A retrospective study
Issued Date
2024-01-01
Resource Type
eISSN
24687855
Scopus ID
2-s2.0-85212324028
Journal Title
Journal of Stomatology, Oral and Maxillofacial Surgery
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Stomatology, Oral and Maxillofacial Surgery (2024)
Suggested Citation
Frech B., Siritongtaworn C., Muangchan C., Tangmanee C., Subbalekha K., Sirintawat N., Meningaud J.P., Pitak-Arnnop P., Stoll C. Risk factors for flap dehiscence and/or necrosis following standard rotational flap in cranial vault osteomyelitis without intracranial involvement: A retrospective study. Journal of Stomatology, Oral and Maxillofacial Surgery (2024). doi:10.1016/j.jormas.2024.102187 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/102498
Title
Risk factors for flap dehiscence and/or necrosis following standard rotational flap in cranial vault osteomyelitis without intracranial involvement: A retrospective study
Corresponding Author(s)
Other Contributor(s)
Abstract
Objectives: The study aimed to estimate the incidence of flap dehiscence and/or necrosis (FD/N) following standard rotational flap (SRF) surgery for cranial vault osteomyelitis without intracranial involvement (CVO) and to identify factors associated with these complications. Methods: A retrospective study was conducted using chart reviews of patients who underwent SRF to cover CVO defects over a 10-year period. Twenty-one predictor variables were analysed, categorised into demographic, health status, anatomic, and surgical factors. The primary outcome was the occurrence of FD/N. Descriptive, bi- and multivariate regression analyses were used to identify variables significantly associated with FD/N (P ≤ 0.05). Results: The study included 154 subjects who underwent SRF (26.6 % female), with a mean age of 75.6 ± 12.8 years (range, 26–94). The incidence of FD/N was 5.2 %. Multivariate analysis revealed that smoking (odds ratio [OR] 1.07; P = 0.04), second surgery (OR 1.18; P < 0.001), compromised scalp vascularity (OR 1.1; P = 0.007), and defects at the central scalp and vertex (OR 1.08; P = 0.02) were statistically significantly associated with an increased risk of FD/N. Conclusions: FD/N is an infrequent complication following SRF for CVO. Significant modifiable risk factors included smoking, multiple flap operations, compromised scalp vascularity, and defects at the central scalp and vertex. Addressing these factors may help reduce the risk of FD/N in this patient population. Future research should investigate outcomes among different flap types for CVO defects.