{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:06:39Z","timestamp":1788930399051,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2013,6,28]],"date-time":"2013-06-28T00:00:00Z","timestamp":1372377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Large defects secondary to oral cancer resection are reconstructed with microsurgical free flaps. Pulmonary complications in these patients are common. Postoperative mobilization is recommended to decrease respiratory complications; however, many microsurgeons are reluctant to adopt early mobilization protocols due to the perceived risk of flap compromise. The purpose of this study was to determine the incidence of pneumonia among patients undergoing oral cancer resection and immediate free flap reconstruction and to compare the incidence of this complication between patients mobilized early (&lt;4 days postoperative) versus later. A secondary goal was to determine whether early postoperative mobilization affected microvascular flap outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixty\u2010two consecutive patients treated between 2005 and 2009 with oral carcinoma resection and free flap reconstruction were studied. Information pertaining to comorbidities, postoperative care, and complications were collected. Risk factors for development of pulmonary and flap complications were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of pneumonia was 30.6%. Longer intensive care unit stay (<jats:italic>P<\/jats:italic>\u2009=\u20090.01), tracheostomy decannulation later than 10 days (<jats:italic>P<\/jats:italic>\u2009=\u20090.04), and longer operative times (<jats:italic>P<\/jats:italic>\u2009=\u20090.04) were significantly associated with pneumonia. Delayed mobilization (after day 4 postoperative) was an independent risk factor for pneumonia (OR\u2009=\u20094.2, 95% CI: 1.1, 17.1). Early mobilization (before day 4 postoperative) was not associated with an increased incidence of secondary flap procedures or flap failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Late mobilization of free flap patients is an independent risk factor for developing postoperative pneumonia. Earlier mobilization does not increase flap failure rates, is safe, and should be strongly considered in all free flap patients to reduce pulmonary complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 123:2996\u20133000, 2013<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24241","type":"journal-article","created":{"date-parts":[[2013,6,11]],"date-time":"2013-06-11T09:26:39Z","timestamp":1370942799000},"page":"2996-3000","source":"Crossref","is-referenced-by-count":46,"title":["Delayed mobilization after microsurgical reconstruction: An independent risk factor for pneumonia"],"prefix":"10.1002","volume":"123","author":[{"given":"Justin K.","family":"Yeung","sequence":"first","affiliation":[{"name":"Division of Plastic &amp; Reconstructive Surgery University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robertson","family":"Harrop","sequence":"additional","affiliation":[{"name":"Division of Plastic &amp; Reconstructive Surgery University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"McCreary","sequence":"additional","affiliation":[{"name":"University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie T.","family":"Leung","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of British Columbia Vancouver British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naushad","family":"Hirani","sequence":"additional","affiliation":[{"name":"Department of Medicine, Respirology University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"McKenzie","sequence":"additional","affiliation":[{"name":"Division of Plastic &amp; Reconstructive Surgery University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vim","family":"de Haas","sequence":"additional","affiliation":[{"name":"Division of Plastic &amp; Reconstructive Surgery University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Wayne","family":"Matthews","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Nakoneshny","sequence":"additional","affiliation":[{"name":"Ohlson Research Initiative, Faculty of Medicine University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph C.","family":"Dort","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiaan","family":"Schrag","sequence":"additional","affiliation":[{"name":"Division of Plastic &amp; Reconstructive Surgery University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,6,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000260591.82762.b5"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0347(199708)19:5<372::AID-HED2>3.0.CO;2-X"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199201000-00008"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23228"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e3180de4d85"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.131.1.27"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-144-8-200604180-00008"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800790807"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc1995.4.5.340"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22454"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200008000-00015"},{"key":"e_1_2_7_13_1","volume-title":"Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine","author":"Hess OM","year":"2007"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20671"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-006-9296-1"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(99)80163-9"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-197810000-00003"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2007.05.001"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.131.7.605"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20758"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.24241","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.24241","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.24241","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.24241","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T18:59:57Z","timestamp":1692471597000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.24241"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6,28]]},"references-count":19,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2013,12]]}},"alternative-id":["10.1002\/lary.24241"],"URL":"https:\/\/doi.org\/10.1002\/lary.24241","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,6,28]]}}}