Skip to Main content Skip to Navigation
Master Thesis

Les facteurs de risque d'échec dans le lambeau libre de fibula : expérience monocentrique de 10 ans au CHU de Caen

Abstract : Introduction: today, the fibula free flap in maxillo-facial reconstruction is the gold standard. The flap failure has a significant impact for the further management. Identification of risk factors would improve the success rate. We have studied influence of venous anastomosis and different characteristics which may have a role on fibula free flap failure. Material and Methods: this was a retrospective study conducted between January 1st, 2008 and December 31, 2017. All adult patients who benefited a fibula free flap in maxillo-facial reconstruction were included. The primary endpoint was viability of the bone flap on the 30th postoperative day. Results: eighty-one patients were included and divided into two groups according to flap viability. There was no significant difference according to the technique of venous anastomosis. Aspirin intake (p=0.03), a neurological history (p=0.01), intraoperative intravenous heparin injection, preventive anticoagulation relayed on day 14 with a platelet antiaggregant for 10 weeks were a factor of success (p=0.003). Single vein anastomosis was a significant risk factor for failure (p = 0.02). Conclusion: identification of risk factors of failure allow to optimizes the already high success rate of the fibula free flap in maxillo-facial reconstruction. Venous anastomosis should be performed in a case-by-case configuration. Rapid re-intervention for anastomosis control also remains an important factor.
Complete list of metadatas

Cited literature [89 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-02321496
Contributor : Ufr Santé Unicaen <>
Submitted on : Monday, October 21, 2019 - 11:53:10 AM
Last modification on : Tuesday, October 20, 2020 - 10:17:22 AM
Long-term archiving on: : Wednesday, January 22, 2020 - 2:25:50 PM

File

DROUET Julien Chir G.pdf
Files produced by the author(s)

Identifiers

  • HAL Id : dumas-02321496, version 1

Citation

Julien Drouet. Les facteurs de risque d'échec dans le lambeau libre de fibula : expérience monocentrique de 10 ans au CHU de Caen. Médecine humaine et pathologie. 2019. ⟨dumas-02321496⟩

Share

Metrics

Record views

26

Files downloads

126