Stevens et al reported predictors for free flap failure following head and neck surgery. These can help to identify a patient who may benefit from more aggressive management. The authors are from Vanderbilt University and University of Texas Southwestern Austin.

Patient selection: reconstruction with free flap over skin defect in the head and neck.


Outcome: early flap failure (< 8 days from surgery)


Predictors of early free flap failure:

(1) female sex (OR 2.6)

(2) peripheral vascular disease (OR 2.8)

(3) elevated preoperative platelet count (OR 2.7)


The risk of free flap failure increases with the number of risk factors present.

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