{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:27:44Z","timestamp":1792682864875,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,12,8]],"date-time":"2017-12-08T00:00:00Z","timestamp":1512691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Diabetes is associated with microvascular pathology and may predispose patients undergoing microvascular surgery to complications. This study assesses diabetes as a risk factor for complications following free flap surgery of the head and neck.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>In this retrospective cohort study, data on free flap surgeries of the head and neck between 2005 and 2014 was collected from the National Surgical Quality Improvement Program (NSQIP) database. A propensity\u2010matching algorithm (PSM) was used to equilibrate distribution of numerous covariates between the diabetic and nondiabetic cohorts. A sub\u2010analysis was performed to examine the impact of insulin\u2010dependency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The initial dataset contained 2187 free flaps of the head and neck. After implementing PSM, a new population was created containing 506 total cases with 253 DM patients. The majority of cases were male and white. The matched cohort did not contain any demographics or comorbidities associated with DM. Complications significantly elevated in the DM group were severe bleeding (<jats:italic>P<\/jats:italic>\u2009=\u2009.046), postoperative ventilation greater than 48 hours (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), and pneumonia (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.048). In patients with insulin\u2010dependent diabetes, reintubation (<jats:italic>P<\/jats:italic>\u2009=\u2009.005), cardiac arrest (<jats:italic>P<\/jats:italic>\u2009=\u2009.010), severe bleeding (<jats:italic>P<\/jats:italic>\u2009=\u2009.006), overall surgical complications (<jats:italic>P<\/jats:italic>\u2009=\u2009.015), and overall complications (<jats:italic>P<\/jats:italic>\u2009=\u2009.005) were significantly increased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study examines the impact of diabetes on postoperative complications following free flap reconstruction of the head and neck. Propensity score matching was utilized. Analysis of the PSM cohort suggests that diabetic patients have elevated rates of postoperative pulmonary complications. Additionally, patients with insulin\u2010dependent diabetes have significantly elevated rates of medical and surgical complications.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30276","type":"journal-article","created":{"date-parts":[[2017,12,8]],"date-time":"2017-12-08T07:44:39Z","timestamp":1512719079000},"page":"504-511","source":"Crossref","is-referenced-by-count":27,"title":["Impact of diabetes on free flap surgery of the head and neck: A NSQIP analysis"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0223-1518","authenticated-orcid":false,"given":"Jacob S.","family":"Brady","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Govindan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan M.","family":"Crippen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrey","family":"Filimonov","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Anderson","family":"Eloy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey"},{"name":"Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey Rutgers New Jersey Medical School Newark New Jersey"},{"name":"Department of Neurological Surgery Rutgers New Jersey Medical School Newark New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soly","family":"Baredes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey"},{"name":"Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey Rutgers New Jersey Medical School Newark New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard Chan Woo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2009.05.003"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2005.11.013"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-6419.2007.00527.x"},{"key":"e_1_2_8_5_1","article-title":"Head and neck microvascular free flap reconstruction: An analysis of unplanned readmissions","author":"Carniol E. T.","year":"2016","journal-title":"Laryngoscope."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/2230-8210.94253"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001250100648"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199701000-00024"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19981015)17:19<2265::AID-SIM918>3.0.CO;2-B"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24189"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182173d3a"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2010.193"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2016.01.009"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-010-1268-1"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature05482"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/918267"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22454"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000249737.05840.29"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00838-5"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2015.249"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000095409.32437.d4"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-010-0335-4"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-014-3024-5"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815607852"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23624"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/70.1.41"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000003026"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000002111"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-014-0490-3"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.1258"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3181763531"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21284"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmicr.30276","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.30276","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T21:15:12Z","timestamp":1694985312000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.30276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,8]]},"references-count":31,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,7]]}},"alternative-id":["10.1002\/micr.30276"],"URL":"https:\/\/doi.org\/10.1002\/micr.30276","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,8]]}}}