Title : Complications and safety of large flap repairs of greater than 60cm² at a tertiary care center
Purpose: This study aimed to assess the incidence of post-operative complications such as infection, bleeding, necrosis, dehiscence, and hospitalization following outpatient dermatologic reconstructions using large adjacent tissue transfer with flap areas of 60 cm² or greater performed under local anesthesia.
Design: Eligible patients were identified through review of the electronic medical records for two dermatologic surgeons at Oregon Health and Science University. A database of patient characteristics, surgical characteristics, and complication rates was compiled. The associations between complication and flap size, flap technique, surgical site, antibiotic use, and antithrombotic use were calculated.
Findings: 278 adjacent tissue transfer procedures met eligibility requirements for this study. The rates of postoperative infection, bleeding or hematoma requiring treatment, flap necrosis or failure, wound dehiscence, and hospitalization were 4.3%, 2.16%, 2.88%, 4.68%, and 1.08%, respectively.
Summary: Complications following large flap reconstruction were infrequent and non-life threatening. The authors results asuggest that large flap reconstruction >60 cm2 can be performed safely in the outpatient setting.