{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T04:08:20Z","timestamp":1778731700344,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,9,24]],"date-time":"2018-09-24T00:00:00Z","timestamp":1537747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Blood product utilization is monitored to prevent unnecessary transfusions. Head\u2010and\u2010neck pedicled flap reconstruction transfusion\u2010related outcomes were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred and thirty\u2010six pedicled flap patients were reviewed: 64 supraclavicular artery island flaps (SCAIF), 57 pectoralis major (PM) flaps, and 15 submental (SM) flaps. Outcome parameters included flap\u2010related complications, medical complications, length of stay (LOS), and flap survival. Multivariable logistic regression analyses were performed. Multivariable logistic regression analyses were performed to adjust for relevant pre\u2010 and perioperative factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of all head\u2010and\u2010neck pedicled flap patients included in our analyses (n\u2009=\u2009136), 40 (29.4%) received blood transfusions. The average pretransfusion hematocrit (Hct) was 24.3%\u2009\u00b1\u20090.5%, with 2.65\u2009\u00b1\u20090.33 units transfused and a posttransfusion Hct increase of 5.0%\u2009\u00b1\u20090.6%. Transfusion rates differed with PM (47.4%), SCAIF (17.2%), and SM (13.3%) flaps (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.005). Patients undergoing PM reconstruction trended toward higher transfusion requirements (PM 2.89\u2009\u00b1\u20090.47 units, SC 2.18\u2009\u00b1\u20090.28 units, and SM 2.00\u2009\u00b1\u20090.0 units), with transfusion occurring later in the postoperative course (4.9\u2009\u00b1\u20091.3 days vs. 2.4\u2009\u00b1\u20090.1 days for all other flaps; <jats:italic>P<\/jats:italic>\u2009=\u20090.08). Infection, dehiscence, fistula, or medical complications were not different. Transfusion thresholds of Hct\u2009&lt;\u200921 versus Hct\u2009&lt;\u200927 exhibited no difference in LOS, flap\u2010survival, or medical\/flap\u2010related complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Transfusion is not associated with surgical or medical morbidity following head and neck pedicled flap reconstruction. There were no differences in outcomes between transfusion triggers of Hct\u2009&lt;\u200921 versus Hct\u2009&lt;\u200927, suggesting that a more conservative transfusion trigger may not precipitate adverse patient complications. Our data recapitulate findings in free flap patients and warrant further investigation of transfusion practices in head and neck flap reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 128:E409\u2013E415, 2018<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27393","type":"journal-article","created":{"date-parts":[[2018,9,24]],"date-time":"2018-09-24T13:15:35Z","timestamp":1537794935000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Transfusion in Head and Neck Cancer Patients Undergoing Pedicled Flap Reconstruction"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2083-3523","authenticated-orcid":false,"given":"Nicholas B.","family":"Abt","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Massachusetts Eye and Ear Harvard Medical School  Boston Massachusetts"},{"name":"Department of Otolaryngology Harvard Medical School  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sidharth V.","family":"Puram","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Massachusetts Eye and Ear Harvard Medical School  Boston Massachusetts"},{"name":"Department of Otolaryngology Harvard Medical School  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumi","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Massachusetts Eye and Ear Harvard Medical School  Boston Massachusetts"},{"name":"Department of Otolaryngology Harvard Medical School  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1508-1363","authenticated-orcid":false,"given":"Rosh K. V.","family":"Sethi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Massachusetts Eye and Ear Harvard Medical School  Boston Massachusetts"},{"name":"Department of Otolaryngology Harvard Medical School  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7783-1097","authenticated-orcid":false,"given":"Neerav","family":"Goyal","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery, Department of Surgery Penn State Milton S. Hershey Medical Center  Hersey Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin S.","family":"Emerick","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Massachusetts Eye and Ear Harvard Medical School  Boston Massachusetts"},{"name":"Department of Otolaryngology Harvard Medical School  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derrick T.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Massachusetts Eye and Ear Harvard Medical School  Boston Massachusetts"},{"name":"Department of Otolaryngology Harvard Medical School  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel G.","family":"Deschler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Massachusetts Eye and Ear Harvard Medical School  Boston Massachusetts"},{"name":"Department of Otolaryngology Harvard Medical School  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,9,24]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"49","article-title":"Recommendations for the transfusion of red blood cells","volume":"7","author":"Liumbruno G","year":"2009","journal-title":"Blood Transfus"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.11.024"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000022460.21283.53"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000127600"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814567107"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000249737.05840.29"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26047"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815573726"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1357275"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24790"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2017.02.006"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002231"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13936"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2015.09.002"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2017.02.016"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.02.076"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/2152-7806.143754"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.0707"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2017.1607"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.27393","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.27393","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T22:42:45Z","timestamp":1694731365000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.27393"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,24]]},"references-count":19,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1002\/lary.27393"],"URL":"https:\/\/doi.org\/10.1002\/lary.27393","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,24]]},"assertion":[{"value":"2018-03-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}