Association between blood transfusions and complications in head and neck reconstruction: a systematic review and meta-a
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REVIEW ARTICLE
Association between blood transfusions and complications in head and neck reconstruction: a systematic review and meta‑analysis Francesco Giovacchini1 · Caterina Bensi2 · Daniele Paradiso3 · Raffaella Docimo4 · Antonio Tullio5 Received: 12 June 2020 / Accepted: 10 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The aim of this meta-analysis is to assess the correlation between blood transfusions and the medical/surgical complications after head and neck reconstructive surgery. Methods The PRISMA protocol was used and the literature search was performed on Pubmed, Scopus, Cochrane Library and Web of Science up to March 13, 2020. The risk of bias in individual studies was assessed through the Newcastle Ottawa Scale. Results A total of 1219 records were screened after the electronic search, 22 of which were included in the qualitative analysis. Of there 22 scores, 18 articles were included in the meta-analysis. The OR for medical and surgical complications of transfused patients was 1,64 (95% CI 1.23–2.21); while, the OR for hospital readmission was 1.53 (95% CI 1.29–1.81). Conclusions The results of this meta-analysis suggested that blood transfusions are associated with both an increased risk of surgical and medical complications of head and neck flaps and with the hospital readmission. Keywords Blood transfusion · Free flap · Pedicled flap · Complications · Hospital readmission
Introduction Nowadays, the use of regional pedicled or free flaps to reconstruct large head and neck defects represents the gold standard in reconstructive surgery with a success rate that accounts for about the 97% [1]. However, much are the surgical and medical complications that may occur during this kind of surgery also increasing the hospital costs due to longer hospital stays and additional medical and surgical
* Caterina Bensi [email protected] 1
Maxillo‑Facial Surgery Unit, Santa Maria Della Misericordia Hospital, Piazza Menghini 1, San Sisto, Perugia, Italy
2
Paediatric Dentistry Post‑Graduate School, University of Rome “Tor Vergata”, Via Montpellier 1, Rome, Italy
3
S.S.D. of Oral Surgery and Ambulatory, Santa Maria Della Misericordia Hospital, Piazza Menghini 1, San Sisto, Perugia, Italy
4
Paediatric Dentistry, Department of Surgical Sciences, University of Rome “Tor Vergata”, Via Montpellier 1, Rome, Italy
5
Maxillo‑Facial Surgery, University of Perugia, Perugia, Italy
interventions with prolonged healing period and recovery [2]. There are independent risk factors that seem to be related to an increased risk of complications, for example, age, malnutrition, cardiovascular diseases, tobacco use, diabetes mellitus, radiation exposure, blood transfusions, anticoagulants, antiplatelets drug and antibiotics administered in the postoperative period [3]. Many specific complications related to blood transfusion have been described such as myocardial infarction, congestive heart failure, arrhythmias, deep vein thrombosis, pulmonary emboli, a
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