Aspects of perioperative management and outcomes of flap surgery at Charlotte Maxeke Johannesburg Academic Hospital

Abstract

Background: Perioperative outcomes of specialised surgeries, such as flap surgery, provide valuable information about the performance and capacity of the unit and facility to provide quality care to patients presenting with conditions that require the abovementioned intervention. Reconstructive flap surgery involves the transfer of tissue from the site of origin to other sites to restore the shape and function of tissue that has been lost. Success rates of 90–99% have been reported worldwide. An audit of the perioperative outcomes at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) has not been described. Therefore, an audit of this nature will reveal standards and practices at the facility. The incidence of flap failure is also unknown. The study aimed to provide an overall description of patients who have undergone flap surgery and to describe the perioperative management and outcomes of patients presenting for flap surgery at CMJAH.

Methods: A retrospective research design was followed in this study, where records of patients who had undergone flap surgery at CMJAH were reviewed. The study population included all patients who presented for and underwent flap surgery from 1 January 2015 to 31 December 2019.

Results: Our analysis included a total of 87 cases. The flap failure rate was 14.9%. Older age and diabetes mellitus were univariably associated with flap failure. Perioperative factors had no influence on flap survival rate. Multivariable regression analysis revealed significantly increased risks of flap failure related to revision surgery (p = 0.017, odds ratio [OR] 9.42).

Conclusion: Flap surgery plays an important role in reconstructive surgery, and the outcomes of these procedures greatly affect patients’ quality of life. The results of our study did not demonstrate the effect of anaesthetic techniques on the outcomes of flap surgeries.