Comparison Of Intracavitary Repair Of Head And Neck Flap With Surface Repair And Analysis Of Related Factors

Objective: to analyze the factors affecting the postoperative necrosis of head and neck flap in the first affiliated hospital of guangxi medical university.Methods: the clinical data of 94 patients undergoing head and neck flap repair and reconstruction from January 2013 to January 2020 were retrospectively analyzed.The factors related to gender,age,BMI(body mass index),smoking history,preoperative radiotherapy history,preoperative tracheotomy history,combined history of hypertension,combined history of diabetes,preoperative and postoperative white blood cell count,preoperative and postoperative albumin,and flap repair type were analyzed for multiple factors.The 2 test or Fisher’s exact probability were used for comparison between groups.Logistic regression was used to analyze the relationship between repair methods and flap necrosis,and the relationship between flap necrosis and flap repair type.Results: among the 94 patients who underwent head and neck flap repair surgery,15 cases showed postoperative flap necrosis,among which the necrosis rate of intracavity repair flap was 25.6%(11/43)and 7.8%(4/51).The difference between the necrosis rate of intracavity repair flap and that of skin flap was statistically significant(2=5.474,P=0.019 < 0.05).Univariate Logistic regression analysis: the repair method was related to the necrosis of the flap,and the risk of skin flap necrosis caused by the intracavitary repair method was4.039 times that of the surface repair method(OR=4.039,95%ci: 1.259-15.610,P=0.026).Gender,age,BMI,preoperative radiotherapy history,tracheotomy history,hypertension,diabetes,smoking history,flap repair type,preoperative white blood cell count,postoperative white blood cell count,preoperative albumin and postoperative albumin were not found to be associated with flap necrosis(P>0.05).By repeated correction multiariable Logistic regression analysis showed that gender,age,BMI,smoking history,history of preoperative radiotherapy,preoperative tracheotomy,merge history of arterial hypertension,history of diabetes mellitus,preoperative postoperative leukocyte count,preoperative postoperative factors such as albumin,intracavitary repair way lead to the risk of flap necrosis is still higher than surface repair method(P < 0.05),with statistical significance.Conclusion: the intracavity repair of the head and neck flap group had a higher risk of necrosis than that of the surface flap group.Gender,age,BMI,preoperative radiotherapy history,tracheotomy history,hypertension,diabetes,smoking history,flap repair type,preoperative white blood cell count,postoperative white blood cell count,preoperative albumin and postoperative albumin were not found to be associated with flap necrosis.