Risk Factors for Postoperative Hematomas in the Patients Undergoing Head and Neck Cancer Reconstruction

Background: Head and neck cancer reconstruction is complicated and requires a lot of time and effort for plastic surgeons to complete the surgery. Although this technique has improved over the past 20 years, free flap failures still occur. Postoperative hematoma is one of the most common complications and may compromise the perfusion of pedicles and perforators. In this study, we reviewed our patients to analyze the risk factors associated with postoperative hematomas.

Material and Methods: This study involved a retrospective chart review at a single institution from 2014 to 2016. We identified the patients undergoing free flap reconstructions for head and neck cancer. Patients with postoperative hematoma requiring surgical intervention were included in this study.

Result: We enlisted 289 patients undergoing head and neck reconstructions. Eighteen patients (6.2%) had postoperative hematomas of which twelve hematomas occurred within the first 3 days and nine in the first 24 hours after the reconstruction surgery. Comorbidities or postoperative blood pressures were not related to hematoma formation. There was a trend for blood pressure fluctuation to increase hematoma formation.

Conclusion: Our study revealed that blood pressure fluctuation tends to increase the risk for postoperative hematomas. We suggest that fluctuations in blood pressre should be controlled.