Comparing the Results of Free Tissue Transfers in Elderly and Young Patients and Risk Assessment

Introduction: With the increase in geriatric patient population, free tissue transfers are more often performed in the elderly. In our study, we searched the effect of advanced age in microsurgery, and compared the findings with other variables.

Methodology and Material: Medical records of 58 free tissue transfers between January 2012 and June 2013 were retrospectively reviewed. Nineteen of the patients were 60 years and older (avg. 67,63, %32,76), and 39 were below 60 (avg. 34,71, %67,24). Besides demographics, ASA (American Society of Anesthesiologists) risk score, comorbid conditions and anatomical locations for surgery (head and neck, extremities, trunk), operative time, need for re-operation, intensive care unit (ICU) and transfusion, length of hospital stay, medical and surgical complications, partial and total flap loss were assessed and categorized. Findings were compared with statistical analysis software.

Results: ASA risk score was found to be significantly higher at the elder group (p < 0,05). None of the other variables were found to be significantly different for age groups. Although none of the age groups implied a significance for need for ICU, location for surgery and operative time were found to have a significant correlation with need for ICU unit. In our series, operative time were correlated with medical complications, but not with surgical complications in statistical terms. Although higher ASA risk scores did not have a negative effect on the incidence of medical complications, statistical analysis presented a tendency of significance (p = 0,053).

Conclusions: In conclusion, age is not an independent variable for microvascular reconstruction in our experience. However; operative time, ASA risk score and location of surgery seem to be more decisive in determining overall success of free tissue transfers.