PMID- 34247960
OWN - NLM
STAT- MEDLINE
DCOM- 20220114
LR  - 20221207
IS  - 1878-0539 (Electronic)
IS  - 1748-6815 (Linking)
VI  - 74
IP  - 12
DP  - 2021 Dec
TI  - Safety of Reconstructive Microsurgery in the Elderly Population: a Multicentric 
      Prospective Study.
PG  - 3281-3288
LID - S1748-6815(21)00299-0 [pii]
LID - 10.1016/j.bjps.2021.05.048 [doi]
AB  - BACKGROUND: Safety of reconstructive microsurgery in elderly patients is still a 
      topic of debate, because no conclusive evidence exists that provides indications 
      and risk evaluation in elderly patients. The purpose of this study, which the 
      Italian Society for Plastic, Reconstructive, and Aesthetic Surgery (SICPRE) has 
      promoted, is to evaluate the safety and the complication risk of elective 
      reconstructive microsurgery in elderly patients as well as to identify patient- 
      or procedure-related risk factors. The secondary aim is to evaluate the 
      predictive role for complications of the Geriatric 8 score (G8). METHODS: A total 
      of 194 consecutive patients from 18 centers, aged 65 or older, who received an 
      elective microsurgical flap between April 2018 and April 2019 were prospectively 
      evaluated. Patient-related, treatment-related, and outcomes data were recorded 
      and statistically analyzed through multiple-adjusted logistic regression models. 
      RESULTS: Our study showed an increased risk of complications and a longer 
      hospitalization in patients aged >/=75 years with the American Society of 
      Anesthesiologists (ASA) score >/=3 (or G8 score </=11) as compared to patients >65 
      years of age and <75 years of age who undergo reconstruction with a microsurgical 
      flap. Instead, flap survival did not significantly vary with age, but was 
      associated only with ASA score >/=3 (or G8 score </=11) and surgeries that last 
      longer than 480 min; however, flap survival (92.3%) was slightly lower than that 
      commonly reported for in the general population. CONCLUSIONS: Reconstructive 
      microsurgery in the elderly is generally safe. The ASA score is easier and 
      quicker than the G8 score and equally useful for risk stratification.
CI  - Copyright (c) 2021 British Association of Plastic, Reconstructive and Aesthetic 
      Surgeons. Published by Elsevier Ltd. All rights reserved.
FAU - Cordova, Adriana
AU  - Cordova A
AD  - Plastic and Reconstructive Surgery. Department of Surgical, Oncological and Oral 
      Sciences. University of Palermo, Italy.
FAU - Toia, Francesca
AU  - Toia F
AD  - Plastic and Reconstructive Surgery. Department of Surgical, Oncological and Oral 
      Sciences. University of Palermo, Italy. Electronic address: 
      francesca.toia@unipa.it.
FAU - Salgarello, Marzia
AU  - Salgarello M
AD  - Istituto di Clinica Chirurgica, Dipartimento Scienze della Salute della Donna e 
      del Bambino, Universita Cattolica del Sacro Cuore e Unita di Chirurgia Plastica, 
      Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
FAU - Pinto, Valentina
AU  - Pinto V
AD  - Plastic Surgery, Policlinico di Sant'Orsola, Bologna, Italy.
FAU - Lucattelli, Elena
AU  - Lucattelli E
AD  - Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, 
      Italy.
FAU - Sgarzani, Rossella
AU  - Sgarzani R
AD  - U.O.Centro Grandi Ustionati, Servizio di Chirurgia Plastica, Ospedale Maurizio 
      Bufalini, Cesena, Italy.
FAU - Figus, Andrea
AU  - Figus A
AD  - Unit of Plastic Surgery, Department of Surgery, Azienda Ospedaliero-Universitaria 
      di Cagliari, University of Cagliari, Cagliari, Italy.
FAU - Cherubino, Mario
AU  - Cherubino M
AD  - Division of Plastic and Reconstructive Surgery, Department of Biotechnology and 
      Life Sciences, University of Insubria, Varese, Italy.
FAU - Bassetto, Franco
AU  - Bassetto F
AD  - Plastic and Reconstructive Surgery Unit, Padova University Hospital, Padova, 
      Italy.
FAU - Santanelli di Pompeo, Fabio
AU  - Santanelli di Pompeo F
AD  - Plastic Surgery, Nesmos Department, Faculty of Medicine and Psychology, 
      University La Sapienza of Rome-Sant'Andrea Hospital, Rome, Italy.
FAU - Bonfirraro, Pier Paolo
AU  - Bonfirraro PP
AD  - Department of Plastic and Reconstructive Surgery, Ospedali Riuniti, Bergamo, 
      Italy.
FAU - Maruccia, Michele
AU  - Maruccia M
AD  - Section of Plastic and Reconstructive Surgery, Department of Emergency and Organ 
      Transplantation (DETO), University of Bari 'Aldo Moro', Bari, Italy.
FAU - Faini, Gianpaolo
AU  - Faini G
AD  - Plastic and Reconstructive Surgery, Spedali Civili Brescia, Brescia, Italy.
FAU - Cigna, Emanuele
AU  - Cigna E
AD  - Department of Translational Research and New Technologies in Medicine and 
      Surgery, University of Pisa, Pisa, Italy.
FAU - Starnoni, Marta
AU  - Starnoni M
AD  - Division of Plastic Surgery, Modena University Hospital, Modena, Italy.
FAU - Baraziol, Roberto
AU  - Baraziol R
AD  - Azienda Sanitaria Universitaria Integrata di Udine, Plastic Surgery Unit, Udine, 
      Italy.
FAU - Riccio, Michele
AU  - Riccio M
AD  - Azienda Ospedaliero Universitaria "Ospedali Riuniti," Ancona, Italy.
FAU - Mazzucco, Walter
AU  - Mazzucco W
AD  - Department of Health Promotion, Maternal and Infant Care, Internal Medicine and 
      Medical Specialties (PROMISE), University of Palermo, Palermo, Italy.
FAU - Rubino, Corrado
AU  - Rubino C
AD  - Plastic Surgery Unit of Oncology and Haematology, Department of Medical, Surgical 
      and Experimental Sciences, Sassari University Hospital Trust, University of 
      Sassari, Sassari, Italy.
FAU - Bonomi, Stefano
AU  - Bonomi S
AD  - Department of Plastic Reconstructive Surgery, Fondazione IRCCS Istituto Nazionale 
      dei Tumori, Milano, Italy.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20210622
PL  - Netherlands
TA  - J Plast Reconstr Aesthet Surg
JT  - Journal of plastic, reconstructive & aesthetic surgery : JPRAS
JID - 101264239
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Graft Survival
MH  - Humans
MH  - Italy
MH  - Male
MH  - Microsurgery/*methods
MH  - Patient Safety
MH  - Postoperative Complications
MH  - Prospective Studies
MH  - Plastic Surgery Procedures/*methods
MH  - Risk Factors
MH  - Surgical Flaps/*transplantation
OTO - NOTNLM
OT  - Complications
OT  - Elderly
OT  - Free flap
OT  - Microsurgery
OT  - Reconstruction
EDAT- 2021/07/13 06:00
MHDA- 2022/01/15 06:00
CRDT- 2021/07/12 05:35
PHST- 2020/11/25 00:00 [received]
PHST- 2021/03/05 00:00 [revised]
PHST- 2021/05/24 00:00 [accepted]
PHST- 2021/07/13 06:00 [pubmed]
PHST- 2022/01/15 06:00 [medline]
PHST- 2021/07/12 05:35 [entrez]
AID - S1748-6815(21)00299-0 [pii]
AID - 10.1016/j.bjps.2021.05.048 [doi]
PST - ppublish
SO  - J Plast Reconstr Aesthet Surg. 2021 Dec;74(12):3281-3288. doi: 
      10.1016/j.bjps.2021.05.048. Epub 2021 Jun 22.