Early Weight-Bearing After Fibula Free Flap Surgery

作者：Minjee Kim, Michael P. Wu, Lauren E. Miller, Charles Meyer, Allen L. Feng, Mark A. Varvares, Daniel G. Deschler, Derrick T. Lin, Jeremy D. Richmon · 发表于：JAMA Otolaryngology–Head & Neck Surgery · 年份：2023 · DOI：10.1001/jamaoto.2023.4024 · 被引用次数：4 · 研究领域：Reconstructive Surgery and Microvascular Techniques、Cleft Lip and Palate Research、Periodontal Regeneration and Treatments

Importance: Despite the widespread use of fibula free flap (FFF) surgery for head and neck reconstruction, there are no studies assessing if early weight-bearing (EWB) affects postoperative recovery, and the timing of weight-bearing initiation following FFF surgery varies considerably across institutions. Therefore, it is important to understand the effect of EWB in these patients and whether it could improve postoperative recovery. Objective: To assess the association of EWB after FFF surgery with donor-site complications, length of stay, and discharge to home status. Design, Setting, and Participants: This retrospective cohort study took place at Massachusetts Eye and Ear, a single tertiary care institution in Boston, Massachusetts. A total of 152 patients who received head and neck reconstruction with a fibula osteocutaneous free flap between January 11, 2010, and August 11, 2022, were included. Exposure: EWB on postoperative day 1 vs non-EWB on postoperative day 2 or later. Main Outcomes and Measures: Patient characteristics, including demographic characteristics and comorbidities, surgical characteristics, donor-site complications, length of stay, and discharge disposition, were recorded. Descriptive statistics and multivariate logistic regressions were used to compute effect sizes and 95% CIs to compare postoperative outcomes in EWB and non-EWB groups. Results: A total of 152 patients (median [IQR] age, 63 [55-70] years; 89 [58.6%] male) were included. The median (IQR) ...