Is after-hours free-flap surgery associated with adverse outcomes?
- Authors
- Lee, KT[Lee, Kyeong-Tae]; Mun, GH[Mun, Goo-Hyun]
- Issue Date
- Apr-2013
- Publisher
- ELSEVIER SCI LTD
- Keywords
- Microsurgery; After-hours surgery; Flap complicati
- Citation
- JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, v.66, no.4, pp.460 - 466
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
- Volume
- 66
- Number
- 4
- Start Page
- 460
- End Page
- 466
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/61039
- DOI
- 10.1016/j.bjps.2012.12.007
- ISSN
- 1748-6815
- Abstract
- Purpose: Recently, there has been increasing interest in system-based approaches to improve patient safety, including the concern of the risks of after-hours surgery. Although several studies have demonstrated worse outcomes associated with night surgery, little is known regarding the effects of after-hours surgery on microsurgery fields. Here, we evaluated the hypothesis that after-hours microsurgery could increase the risk of postoperative complications. Methods: A retrospective case-control study was performed of patients who underwent elective microsurgical reconstruction between January 2004 and March 2012. Patients were categorised into an after-hours group defined as an operation starting between 4 pm and 7 am or a daytime group defined as an operation starting between 7 am and 4 pm. Results: A total of 454 patients were included, with 345 patients in the daytime group and 109 patients in the after-hours group. Flap-compromised complications were observed in 24 patients (5.3%), including 13 (2.9%) total losses and 11 (2.4%) partial losses. After-hours surgery was associated with a higher risk of total flap loss (p = 0.011) and re-exploration (p = 0.004), which remained significant in multivariate analysis (p = 0.018; p = 0.002). Total flap salvage was possible in 18 of 31 (58.1%) of re-explorations, and a significantly higher success rate was observed in the daytime group (p = 0.027). Total length of hospital stay was significantly longer in the after-hours group (p = 0.039). Minor complication rates did not show significant differences between the groups. Conclusions: After-hours performance of elective free flap surgery was demonstrated to be associated with increased risk of flap-related complications. (C) 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - Medicine > Department of Medicine > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.