A Comparison of Free Tissue Transfers to the Head and Neck Performed by Sugeons and Otolaryngologists.

BACKGROUND

The reconstruction of defects resulting from the extirpation of head and neck neoplasms is performed by both otolaryngology and plastic surgery services, mostly dependent on the institution. The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) provides a unique opportunity to examine a predefined set of variables with regard to free vascularized tissue transfers performed by each service.

METHODS

Following institutional review board approval, the NSQIP Participant Use Files for 2005 to 2011 were examined for all Current Procedural Terminology codes regarding free tissue transfer and with primary ICD-9 codes indicating a head and neck neoplasm. Each record was examined to determine which service performed the free tissue reconstruction and subsequent outcomes.

RESULTS

During this time period a total of 534 flaps were performed, 213 by plastic surgery and 321 by otolaryngology. Total hospital length of stay was 12.9 and 11.2 days for plastic surgery and otolaryngology, respectively (P < 0.05). There were no significant differences noted between surgical site infections, wound dehiscence, and flap failure. Patients undergoing flaps performed by plastic surgery were significantly more likely to be on a ventilator 48 hours postoperatively (P < 0.005). Plastic surgery performed a significantly increased number of osseous flaps compared with otolaryngology (P < 0.05).

CONCLUSIONS

This study shows similar results with regard to free vascularized tissue transfers when performed by plastic surgery and otolaryngology. Slightly longer hospital stays and longer time spent on the ventilator may be associated with the increased number of osseous flaps performed by plastic surgery.