Volume 129, Issue 4 pp. 837-840

Facial Plastics/Reconstructive Surgery

Higher Complication Rates in Self-Inflicted Gunshot Wounds After Microvascular Free Tissue Transfer

Mofiyinfolu Sokoya MD,

Mofiyinfolu Sokoya MD

orcid.org/0000-0002-4294-8532

Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, U.S.A

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Aurora G. Vincent MD,

Aurora G. Vincent MD

Department of Otolaryngology–Head and Neck Surgery, Madigan Army Medical Center, Tacoma, Washington, U.S.A

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Rohan Joshi MD,

Rohan Joshi MD

Department of Otolaryngology–Head and Neck Surgery, New York–Presbyterian Hospital of Columbia and Cornell, New York, New York, U.S.A

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Sameep Kadakia MD,

Sameep Kadakia MD

orcid.org/0000-0002-5811-3791

Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, U.S.A

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Scott Kohlert MD,

Scott Kohlert MD

orcid.org/0000-0003-1814-0776

Department of Facial Plastic and Reconstructive Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas, U.S.A

Department of Otolaryngology–Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada

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Thomas S. Lee MD,

Thomas S. Lee MD

Department of Otolaryngology–Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia, U.S.A

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Masoud Saman MD,

Masoud Saman MD

Saman Facial Plastics, Plano, Texas, U.S.A

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Yadranko Ducic MD,

Corresponding Author

Yadranko Ducic MD

[email protected]

Department of Facial Plastic and Reconstructive Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas, U.S.A

Send correspondence to Yadranko Ducic, MD, Department of Facial Plastic and Reconstructive Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX. E-mail: [email protected].Search for more papers by this author

Mofiyinfolu Sokoya MD,

Mofiyinfolu Sokoya MD

orcid.org/0000-0002-4294-8532

Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, U.S.A

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Aurora G. Vincent MD,

Aurora G. Vincent MD

Department of Otolaryngology–Head and Neck Surgery, Madigan Army Medical Center, Tacoma, Washington, U.S.A

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Rohan Joshi MD,

Rohan Joshi MD

Department of Otolaryngology–Head and Neck Surgery, New York–Presbyterian Hospital of Columbia and Cornell, New York, New York, U.S.A

Search for more papers by this author

Sameep Kadakia MD,

Sameep Kadakia MD

orcid.org/0000-0002-5811-3791

Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, U.S.A

Search for more papers by this author

Scott Kohlert MD,

Scott Kohlert MD

orcid.org/0000-0003-1814-0776

Department of Facial Plastic and Reconstructive Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas, U.S.A

Department of Otolaryngology–Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada

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Thomas S. Lee MD,

Thomas S. Lee MD

Department of Otolaryngology–Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia, U.S.A

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Masoud Saman MD,

Masoud Saman MD

Saman Facial Plastics, Plano, Texas, U.S.A

Search for more papers by this author

Yadranko Ducic MD,

Corresponding Author

Yadranko Ducic MD

[email protected]

Department of Facial Plastic and Reconstructive Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas, U.S.A

First published: 24 September 2018

https://doi.org/10.1002/lary.27391

Citations: 9

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objectives/Hypothesis

Microvascular free tissue transfer is often employed to reconstruct significant facial defects from ballistic injuries. Herein, we present our comparison of complications between self-inflicted and non–self-inflicted gunshot wounds after microvascular free tissue transfer.

Study Design

Retrospective case review.

Methods

Approval was obtained from the JPS institutional review board. We performed a retrospective review of cases of ballistic facial injuries between October 1997 and September 2017 that underwent vascularized free tissue transfer for reconstruction. Comparisons were made between self-inflicted and non–self-inflicted gunshot wounds after microvascular free tissue transfer. The χ² test was used for all comparisons. P value and 95% confidence interval (CI) were reported.

Results

There were 73 patients requiring free flap reconstruction after gunshot wounds to the face during the study period. There was a statistically significant difference in the rates of nonunion between self-inflicted and non–self-inflicted wounds (P = .02, 95% CI: 0.9 to 35.8) There were also no significant differences in flap failure (P = .10, 95% CI: −2.8 to 24.2), plate exposure (P = .28, 95% CI: −6.7 to 33.0), wound infection (P = .40, 95% CI: −8.9 to 31.2), scar contracture (P = .60, 95% CI: −8.1 to 25.1), and fistula formation (P = .13, 95% CI: −2.8 to 28.8) between patients with self-inflicted and those with non–self-inflicted wounds. Overall, complication rates were significantly higher in the self-inflicted group compared to the non–self-inflicted group (P < .0001, 95% CI: 32.6 to 68.6).

Conclusions

Patients with self-inflicted injuries had more complications postoperatively than those with non–self-inflicted injuries. This is likely helpful in surgical planning and patient counseling.

Level of Evidence

4 Laryngoscope, 129:837–840, 2019

BIBLIOGRAPHY

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Citing Literature

Volume129, Issue4

April 2019

Pages 837-840

Higher Complication Rates in Self-Inflicted Gunshot Wounds After Microvascular Free Tissue Transfer

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Information

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Higher Complication Rates in Self-Inflicted Gunshot Wounds After Microvascular Free Tissue Transfer

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Related

Information