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Our study focused on the association between DM and individual complications regarding both surgical and medical aspects. A meta-analysis of English-language articles comparing a series of complications between DM and non-DM H&amp;N free-flap recipients was performed by comprehensive meta-analysis (CMA). Twenty-seven articles presented 14,233 H&amp;N free-flap reconstructions, and a subset of 2329 analyses including diabetic cases was included for final analysis. Total postoperative (RR\u2009=\u20091.194, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; OR\u2009=\u20091.506, <jats:italic>p<\/jats:italic>\u2009=\u20090.030) and surgical (RR\u2009=\u20091.550, <jats:italic>p<\/jats:italic>\u2009=\u20090.001; OR\u2009=\u20093.362, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) complications were increased in DM subjects. Free-flap failure\/necrosis (RR\u2009=\u20091.577, <jats:italic>p<\/jats:italic>\u2009=\u20090.001; OR\u2009=\u20091.999, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) and surgical site infections (OR\u2009=\u20092.414, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were also increased in diabetic recipients. However, return to the operating room, dehiscence, fistulas, plate exposures, readmissions, and mortalities were not increased in DM patients. DM increased various complications in H&amp;N free-flap reconstructions. Surgical indications should be cautiously evaluated, and aggressive treatments should be implemented for high-risk recipients.<\/jats:p>","DOI":"10.1038\/s41598-021-85410-3","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T11:14:42Z","timestamp":1615893282000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Clinical consequences of head and neck free-flap reconstructions in the DM population"],"prefix":"10.1038","volume":"11","author":[{"given":"Ting-Han","family":"Chiu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Kan","family":"Tsao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng-Nan","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jou-Wei","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juey-Jen","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,16]]},"reference":[{"key":"85410_CR1","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1002\/hed.21284","volume":"32","author":"CH Wong","year":"2010","unstructured":"Wong, C. 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