Background: Head and neck cancer remains one of the commonest cancers around the world. Risk factors of unfavorable outcome like surgical site infection (SSI) and flap loss are repeatedly reported without definitive conclusion. The aim of this study is to identify the potential influencing factors in patients undergoing head and neck reconstruction.
Methods: This single center cohort study included 596 patients who underwent head and neck reconstruction between 2015 and 2017. Patients were divided first into two groups based on the development or not of SSI, and similar comparison was performed after separating the patients by occurrence or not of flap loss. The demographic and operative data were analyzed further with univariate and multivariate logistic regression.
Result: The overall SSI rate was 18.29%, with the patient’s age (65-74 years, adjusted OR 2.41, p < 0.001; > 74 years, adjusted OR 3.53, p < 0.001) and segmental mandibulectomy (adjusted OR 1.81, p = 0.035) being the independent risk factors. The overall flap failure rate was 4.4%; usage of medial sural flap (adjusted OR 6.89; p = 0.025) and prolonged operative time per hour (adjusted OR 1.38; p < 0.001) were shown to be important influencing factors. Gender, tumor characteristics, and comorbidities did not present statistical significance after multivariate analysis.
Conclusion: We found that the SSI incidence was associated with age and segmental mandibulectomy, meanwhile medial sural flap and operative time were significant in the flap loss rate. Knowing the risk factors can help the operators to improve the flap outcome before head and neck reconstruction.