Free Flap Reconstruction of the Extremities in Patients Who are ≥65 Years Old: A Single-Center Retrospective 1-to-1 Matched Analysis

Figures & data

Table 1 Characteristics of the Older Patients and the Young Control Group

	Older Patients n = 48	Young Control Group n = 133	P-value
Age (years)	75.8 (65–89)	48.8 (18–64)	p<0.0001
Male sex	23 (48%)	103 (77%)	p=0.0002
Female sex	25 (52%)	30 (23%)
Arterial hypertension	28 (58%)	55 (41%)	p=0.06
Type 2 diabetes mellitus	13 (27%)	33 (25%)	P=0.85
Obesity	12 (25%)	38 (29%)	P= 0.71
Class I (30.0–34.9 kg/m2)	9 (19%)	20 (15%)
Class II (35.0–39.9 kg/m2)	3 (6%)	12 (9%)
Class III (≥40.0 kg/m2)	0 (0%)	6 (4%)
Hyperlipoproteinaemia	18 (38%)	45 (34%)	p=0.72
Nicotine abuse	12 (25%)	43 (32%)	p=0.377
Alcohol consumption	15 (31%)	44 (34%)	p=0.86

Note: Data are presented as number (percentage).

Table 2 Comparing the Necrosis Rate Among the Older Patients and the Young Control Group

Indication	Older Patients (n=48)	Young Control Group (n=133)	P-value
	Total (n)/Necrosis (n)	Total (n)/Necrosis (n)
Open fracture (Gustilio grade 2–3)^Citation43	5/0	24/4	p>0.99
Post-trauma soft tissue defect	18/4	73/14	p=0.75
Infection	16/4	18/1	p=0.35
Cancer	8/1	9/1	p>0.99
Burn	1/0	6/2	p>0.99
Decubitus	0/0	3/1
Type of free flap
Anterolateral thigh flap	30/6	64/9	p=0.55
Latissimus dorsi flap	12/2	58/6	p=0.62
Lateral arm flap	3/0	3/0	p>0.99
Rectus/DIEP flap	2/0	5/3	p=0.43
Vastus lateralis flap	1/0	3/0	p>0.99
Recipient side
Foot	8/3	23/2	P>0.09
Ankle	9/3	8/1	p>0.60
Lower leg	14/2	60/9	p>0.99
Upper leg/knee	9/0	15/0	p>0.99
Hand/forearm	8/1	18/5	p>0.65
Lumbar spine	0	3/0
Head/neck/axilla	0	6/2
Veins
One vein	16/4	38/6	p=0.46
Two veins	32/5	90/14	p>0.99
Superficial + deep	6/2	18/5	p>0.99
Deep + deep	26/3	72/9	p>0.99

Note: Open fractures were graded using Gustilio’s classification system.⁴³

Abbreviation: DIEP, deep inferior epigastric perforator.

Table 3 Comparing the Necrosis Rate via 1:1 Matching of the Older Patients and the Young Control Group

Indication	Older Patients (n=38)	Young Control Group (n=38)	P-value
	Total (n)/Necrosis (n)	Total (n)/Necrosis (n)
Open fracture (Gustilio grade 2–3)^Citation43	3/1	3/0	p>0.99
Post-trauma soft tissue defect	17/2	17/4	p=0.66
Infection	15/1	15/3	p=0.60
Cancer	3/1	3/1	p>0.99
Type of free flap
Anterolateral thigh flap	23/1	23/6	p=0.10
Latissimus dorsi flap	12/2	12/2	p>0.99
Lateral arm flap	3/2	3/0	p=0.4
Recipient side
Foot	5/0	5/3	p=0.17
Ankle	3/0	3/1	p>0.99
Lower leg	16/3	16/3	p>0.99
Upper leg/knee	7/0	7/0	p>0.99
Hand/forearm	7/2	7/1	p>0.99
Veins
One vein	9/2	12/4	p=0.66
Two veins	28/3	25/4	p=0.70
Superficial + deep	9/2	5/1	p>0.99
Deep + deep	19/3	20/3	p>0.99
Hospital stay (days)	28.7 ± 19.2	30.4 ± 22.1	p=0.85
Operation time (min)	284.3 ± 81.8	262.6 ±49.7	p=0.16
Flap dimensions
Length (cm)	11.2 ± 4.9	12.8 ± 6.3	p=0.26
Width (cm)	8.2 ± 5.5	8.4 ± 4.1	p=0.24
BMI (kg/m2)	26.6 ± 6.3	26.5 ± 4.5	p=0.86
Nicotine abuse	10/0	11/3	p=0.21
Type 2 diabetes	10/1	10/2	p>0.99
Peripheral artery occlusive disease	2/2	5/2	p=0.43

Note: Open fractures were graded using Gustilio’s classification system.⁴³

Abbreviation: BMI, body mass index.

Paul HK, Seth SL. Gustilo-Anderson Classification. Clin Orthop Relat Res. 2012;470:3270–3274. doi:10.1007/s11999-012-2376-622569719

 PubMed Web of Science ®Google Scholar