{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:42:55Z","timestamp":1760985775677,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T00:00:00Z","timestamp":1554336000000},"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":["Microsurgery"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Microvascular reconstruction is the standard of care in head and neck reconstruction, though its perioperative safety in an older population has been controversial due to safety concerns, warranting further investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>An \u201colder\u201d (\u226571\u2009years) cohort undergoing reconstruction after mandibulectomy\/glossectomy was compared to the remaining population in a National Surgical Quality Improvement Program (2008\u20132016) analysis. Cases required both a mandibulectomy\/glossectomy and microvascular or local flap reconstruction (exclusion criteria: missing ages and simultaneous microvascular and local flap reconstruction). Demographics, comorbidities, and procedure types were analyzed on 985 patients (236 [24.4%] were \u226571). Outcomes were compared by reconstruction type. Regressions were performed calculating the impact of age on length of hospital stay (LOHS) and operative time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ablative procedures were comparable, but older patients received local flaps at higher rates (22.5% vs. 9.6%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). The older population had more comorbidities (higher ASA class [<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001], diabetes [<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001], and hypertension [<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001]). After Bonferroni correction, univariate subgroup analyses of soft tissue and bone\/composite microvascular flaps revealed similar outcomes (except increased medical complications in the older cohort undergoing a bone free flap [<jats:italic>p<\/jats:italic>\u2009=\u2009.002]). Controlling for a variety of factors, older age resulted in longer LOHS (B: 1.4 days; 95% CI: 0.1\u20132.8 days; <jats:italic>p<\/jats:italic>\u2009=\u2009.035), but not operative time (B: \u221221.90\u2009min; 95% CI: \u221252.76 to 8.96\u2009min; <jats:italic>p<\/jats:italic>\u2009=\u2009.164).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While increased age (\u226570\u2009years) was associated with a longer LOHS, complication rates were comparable. Although limited by the retrospective nature, evidence supports microvascular reconstruction in the elderly population with comparable outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30455","type":"journal-article","created":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T07:32:32Z","timestamp":1554363152000},"page":"487-496","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Impact of advanced age on microvascular reconstruction of the lower facial third: An American College of Surgeons NSQIP study"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1964-7109","authenticated-orcid":false,"given":"Sina J.","family":"Torabi","sequence":"first","affiliation":[{"name":"Department of Surgery (Section of Plastic and Reconstructive Surgery) Yale University School of Medicine  New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fouad","family":"Chouairi","sequence":"additional","affiliation":[{"name":"Department of Surgery (Section of Plastic and Reconstructive Surgery) Yale University School of Medicine  New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Dinis","sequence":"additional","affiliation":[{"name":"Department of Surgery (Section of Plastic and Reconstructive Surgery) Yale University School of Medicine  New Haven Connecticut"},{"name":"Department of Medical School, Quinnipiac University, Frank H. 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