{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T09:21:17Z","timestamp":1787908877822,"version":"build-2784847793"},"reference-count":47,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Recent literature advocates restrictive transfusion thresholds (Hb &lt;\u20097\u2009g\/dL). The aim of this study was to evaluate if postoperative hemoglobin levels and transfusions influence Free Flap Revision (FFR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single center retrospective study included all patients who underwent head and neck surgery with free flap reconstruction (other than radial forearm free flap) from 2020 to 2024. A restrictive transfusion strategy was applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 259 patients included, 21.6% underwent FFR for flap compromise or dehiscence. Active smoking (OR 2.20;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019) and hypoalbuminemia were associated with FFR (OR 1.06;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.075) in multivariable analysis. Daily and minimum postoperative (but prerevision) hemoglobin values and the frequency of blood transfusions were not associated with FFR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this study, when applying a restrictive transfusion threshold (&lt;\u20097\u2009g\/dL), postoperative hemoglobin levels and transfusion rates within the observed range were not associated with FFR. This is consistent with the safety of restrictive transfusion practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70434","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:47:52Z","timestamp":1787564872000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative Hemoglobin and Transfusion Rates Do Not Influence Revision of Head and Neck Free Flap in a Cohort of 259 Patients"],"prefix":"10.1002","author":[{"given":"Olivier","family":"Gilbert","sequence":"first","affiliation":[{"name":"Department of Anesthesiology University Cancer Institute of Toulouse\u2014Oncopole, University of Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7068-3500","authenticated-orcid":false,"given":"Agn\u00e8s","family":"Dupret\u2010Bories","sequence":"additional","affiliation":[{"name":"Department of Surgery University Cancer Institute of Toulouse\u2014Oncopole, Toulouse University Hospital, University of Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Staes","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University Cancer Institute of Toulouse\u2014Oncopole, University of Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Ducos","sequence":"additional","affiliation":[{"name":"Intensive Care and Resuscitation Unit University of Toulouse, CHU Toulouse, IUCT\u2010Oncopole  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc Nguyen","family":"Van Phi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University Cancer Institute of Toulouse\u2014Oncopole, University of Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Cabos","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University Cancer Institute of Toulouse\u2014Oncopole, University of Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muriel","family":"Picard","sequence":"additional","affiliation":[{"name":"Intensive Care and Resuscitation Unit University of Toulouse, CHU Toulouse, IUCT\u2010Oncopole  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charline","family":"Berthier","sequence":"additional","affiliation":[{"name":"Department of Surgery University Cancer Institute of Toulouse\u2014Oncopole, Oncopole Claudius Regaud, University of Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathilde","family":"Morisseau","sequence":"additional","affiliation":[{"name":"Biostatistics &amp; Health Data Science Unit University of Toulouse, Oncopole Claudius Regaud, University Cancer Institute of Toulouse\u2014Oncopole  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4113-2846","authenticated-orcid":false,"given":"Emilien","family":"Chabrillac","sequence":"additional","affiliation":[{"name":"Department of Surgery University Cancer Institute of Toulouse\u2014Oncopole, Oncopole Claudius Regaud, University of Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21284"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e3181644abd"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000011158"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-014-3489-1"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2016.10.004"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-019-07675-3"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27417"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13741-022-00244-5"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.11.024"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000003868"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818757949"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.70021"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2016.09.025"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.70115"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-020-06286-z"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2023.106461"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-022-00588-4"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2012.08.028"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814567107"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jormas.2022.03.005"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2020.07.213"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24847"},{"issue":"5","key":"e_1_2_11_24_1","first-page":"516","article-title":"Transfusion as a Predictor of Recurrence and Survival in Head and Neck Cancer Surgery Patients","volume":"39","author":"Chau J. K. M.","year":"2010","journal-title":"Journal of Otolaryngology\u2014Head & Neck Surgery"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.1215"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603013"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.12914"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2019.05.001"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2021.103268"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.4103\/cjop.CJOP-D-22-00115"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31823ed606"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2017.12.026"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000006035"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2022.0016"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199902113400601"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.2981"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.20841"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1159\/000395686"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2017.07.003"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002008"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27289"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.0295"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2023.4551"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2020.07.020"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1177\/00031348241278019"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2015.07.005"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481708301123"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2011.06.002"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.70434","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hed.70434","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.70434","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T09:02:32Z","timestamp":1787907752000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.70434"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,24]]},"references-count":47,"alternative-id":["10.1002\/hed.70434"],"URL":"https:\/\/doi.org\/10.1002\/hed.70434","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"value":"1043-3074","type":"print"},{"value":"1097-0347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,24]]},"assertion":[{"value":"2026-02-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"hed.70434"}}