Burkhard et al reported nomograms for problems after free flap placement during head and neck reconstructions. One nomogram predicts the need for surgical revision. The authors are from Bern University in Switzerland.
Patient selection: free flap with microvascular reconstruction
Parameters:
(1) flap type
(2) diuretic therapy
(3) nadir hemoglobin in g/L, from 75 to 125 g/L
points for hemoglobin =
= 250 - (2 * (hemoglobin))
Parameter
Finding
Points
flap type
osseous
53.2
non-osseous
0
diuretic therapy
no
0
yes
68.5
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 221.7
value of X =
= (0.01997 * (score)) - 2.936
percent surgical revisions =
= 1/(1+EXP((-1)*X))
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