{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:52:35Z","timestamp":1791931955777,"version":"4.3.4"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":34,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The fibula free flap (FFF) remains the workhorse flap for head and neck defects necessitating osteocutaneous reconstruction. Although lower extremity angiography, ultrasound (US), and other vascular studies are routinely used for fibula assessment and patient selection, predictors of donor\u2010site morbidity following harvest remain poorly understood. We sought to investigate the factors associated with FFF donor\u2010site complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective analysis of patients at a tertiary care center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 119 patients undergoing FFF reconstruction during the years 2012 to 2022 were included. Multivariable logistic regression was used to identify independent predictors of soft\u2010tissue donor\u2010site wound complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 48 (40.3%) patients developed a donor\u2010site wound complication with an average time to diagnosis of 24 days (\u00b116) following surgery. In multivariable regression, history of alcohol use disorder (<jats:italic>P<\/jats:italic>\u2009=\u2009.0083) and method of donor\u2010site closure (<jats:italic>P<\/jats:italic>\u2009=\u2009.0368) were independent predictors of donor\u2010site wound complications. Split\u2010thickness skin graft closure was associated with a 146% increased odds of wound complications (odds ratio [OR]\u2009=\u20092.46, 1.11\u20105.43, 95% confidence interval). Patient age, body mass index, Charlson comorbidity index, skin paddle size, and Doppler US characteristics were not predictive of postoperative donor\u2010site morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Predictors of FFF donor\u2010site wound complications included history of alcohol abuse and method of donor\u2010site closure. This study highlights unique lower extremity Doppler US findings in patients undergoing FFF reconstruction in addition to modifiable risk factors associated with fibula donor\u2010site morbidity and soft\u2010tissue complications. Our findings underscore the need to critically evaluate wound closure techniques in this population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oto2.70126","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T02:19:15Z","timestamp":1746497955000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Predictors of Donor\u2010Site Wound Complications Following Fibula Free Flap Reconstruction"],"prefix":"10.1002","volume":"9","author":[{"given":"Soroush","family":"Ershadifar","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California\u2013Davis Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Colback","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California\u2013Davis Sacramento California 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