Risk Factors Of Free Skin Flap Necrosis:Multivariate Logistic Regression Analysis

Objective:We summarized the surgical treatment of the free anterolateral thigh flaps of our hospital and explored the factors that affect the survival of the free flap,so as to avoid the necrosis of the flap and improve the survival rate.Methods:The characteristics of the free anterolateral thigh flaps,the complications of flap,the methods of vascular anastomosis,the number of venous anastomosis,the survival of flap and the long-term curative effects were analyzed in our hospital from August 2001 to October 2016 in 188 cases retrospective analysis.We used the statistical principles to analyze the risk factors of skin flap necrosis and explore the correlation.Results:The total of 188 patients whose mean age was 40,and 165(77.5%)of them were men,while 23(22.5%)were women were evaluated.There were 157 patients with normal,2 patients with diabetes,26 patients with hypertension,3 patients with hypertension and diabetes.Traumatic patients with 175 cases,trauma that is high-energy injury including: car accident injury,machine injury,heavy parts injury,animal bites injury,burns injury and so on.There are 13 non-traumatic cases,including: infection or skin necrosis after ulcer,scar contracture after injury,skin defect after resection and so on.174 case of postoperative flaps survived and 14 cases died.23 case of patients in blood vessel crisis,13 case of patients in blood vessel probe,postoperative flap detection rate was 6.91%(international standard 9.9%)and survival rate of detection was 2.66%.The univariate analysis tests: the number of venous vessels anastomosis,flap hematoma and vascular crisis were considered statistically significant with free skin flap.The multivariate logistic regression analysis tests: the number of venous vessels anastomosis,flap hematoma and vascular crisis were statistically significant with free skin flap.Conclusion:The number of venous vessels anastomosis,flap hematoma and vascular crisis are risk factors for free flap necrosis: the consistent with venous number(> 2)could ensure that the skin flap blood flowing;intraoperative complete hemostasis and postoperative drainage can prevent the formation of subcutaneous hematoma;the application of anticoagulant drugs and antispasmodic drugs in intraoperative and postoperative can prevent patients from arterial crisis,artery spasm and vein crisis.