{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T20:09:46Z","timestamp":1779912586521,"version":"3.53.1"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,5,30]],"date-time":"2014-05-30T00:00:00Z","timestamp":1401408000000},"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":[[2014,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Morbidity of free tissue transfer in the elderly patient is controversial. Recent studies have shown no significant difference in elderly fasciocutaneous free\u2010flap donor site morbidity. The purpose of this study is to assess surgical outcomes in elderly patients receiving osteocutaneous free\u2010tissue transfer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review of patients 70 years and older undergoing osteocutaneous free flaps from 2000 to 2013.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fibular, radial forearm, and scapular flaps were reviewed. Younger patients randomly selected from the same time period served as controls. Data collected included donor site morbidity, flap complications, feeding tube and tracheostomy dependence, and hospital stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010four osteocutaneous free flaps were performed in elderly patients. Overall, there was no significant difference in donor site morbidity between older and younger patients (<jats:italic>P<\/jats:italic>\u2009=\u20090.50) (tendon exposure, <jats:italic>P<\/jats:italic>\u2009=\u20091.00; split\u2010thickness skin graft loss, <jats:italic>P<\/jats:italic>\u2009=\u20090.36; infections, <jats:italic>P<\/jats:italic>\u2009=\u20090.52; dehiscence, <jats:italic>P<\/jats:italic>\u2009=\u20091.00; and seroma, <jats:italic>P<\/jats:italic>\u2009=\u20091.00). There was no significant difference between older and younger patients being decannulated (<jats:italic>P<\/jats:italic>\u2009=\u20090.61) or the time to decannulation (<jats:italic>P<\/jats:italic>\u2009=\u20090.24). There was no difference in those who returned to baseline diet (<jats:italic>P<\/jats:italic>\u2009=\u20090.67). All patients returned to baseline ambulatory and shoulder status. Length of postoperative hospitalization (<jats:italic>P<\/jats:italic>\u2009=\u20090.78) and intensive care unit stay (<jats:italic>P<\/jats:italic>\u2009=\u20090.94) were also equal. The only significant difference was that more elderly patients were discharged to skilled nursing facilities (SNF) (40.9% vs. 15.9%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elderly patients undergoing free tissue transfer have similar flap and donor site outcomes, feeding tube and tracheostomy outcomes, ambulatory status, and hospital stays compared to younger patients. They are, however, more likely to require SNF care posthospitalization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 124:2484\u20132488, 2014<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24762","type":"journal-article","created":{"date-parts":[[2014,5,30]],"date-time":"2014-05-30T14:10:38Z","timestamp":1401459038000},"page":"2484-2488","source":"Crossref","is-referenced-by-count":33,"title":["Surgical outcomes in the elderly patient after osteocutaneous free flap transfer"],"prefix":"10.1002","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5943-6664","authenticated-orcid":false,"given":"Tyler S.","family":"Weaver","sequence":"first","affiliation":[{"name":"School of Medicine and the  Oregon Health and Science University Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob L.","family":"Wester","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery University of California Los Angeles Los Angeles California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Gleysteen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Oregon Health and Science University Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica J.","family":"Peck","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Oregon Health and Science University Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark K.","family":"Wax","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Oregon Health and Science University Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,5,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313480306901109"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2880140104"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)80091-1"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.124.4.407"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0347(199805)20:3<216::AID-HED6>3.0.CO;2-3"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2002.122704"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10240"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000187135.49423.9f"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03315.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.1138"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-194105000-00004"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2010.01.028"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2013.06.012"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-0690(18)30494-4"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-42630"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/003655402_000028041"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.04.011"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-010-0468-4"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.2310\/7070.2005.5001"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23775"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811430897"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199908000-00007"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.131.7.571"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2000.110865"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20791"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.1615"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.1802"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2009.05.043"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20113"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20635"}],"container-title":["The 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