{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:16:51Z","timestamp":1792088211165,"version":"4.4.0"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:00:00Z","timestamp":1668556800000},"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":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether prolonged operative time is negatively associated with post\u2010operative complications and length of stay in patients undergoing microvascular free flap reconstruction for complex head and neck defects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>342 consecutive patients undergoing microvascular reconstruction for head and neck defects between 2017\u20132019 at a single institution were evaluated. Operative outcomes and operative time were compared whilst controlling for patient and treatment related factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean operative time was 551\u2009min and length of stay was 16.2\u2009days. An 11% increase in the risk of a post\u2010operative complication was observed for every additional hour of operative time (OR 1.11, 95% CI 1.03\u20131.21,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.011) after adjusting for patient and treatment factors. A cut\u2010off of 9\u00a0h yielded a 92% increase in complications on either side of this (OR 1.92, 95% CI 1.18\u20133.13,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.009). Increased operative time was also associated with increased length of stay and return to theatres, but not medical complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prolonged operative time is significantly associated with increased surgical complications, length of stay and return to theatres when performing microvascular reconstructive surgery for head and neck defects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.14000","type":"journal-article","created":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T04:49:42Z","timestamp":1667364582000},"page":"175-181","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Effect of operative time on complications associated with free flap reconstruction of the head and neck"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3321-7332","authenticated-orcid":false,"given":"Nina","family":"Irawati","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Every","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Dawson","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Leinkram","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Elliott","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health Sciences, Sydney Medical School The University of Sydney  Sydney New South Wales Australia"},{"name":"Royal Prince Alfred Institute of Academic Surgery Sydney Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Ch'ng","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health Sciences, Sydney Medical School The University of Sydney  Sydney New South Wales Australia"},{"name":"Royal Prince Alfred Institute of Academic Surgery Sydney Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert","family":"Low","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health Sciences, Sydney Medical School The University of Sydney  Sydney New South Wales Australia"},{"name":"Royal Prince Alfred Institute of Academic Surgery Sydney Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten E.","family":"Palme","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health Sciences, Sydney Medical School The University of Sydney  Sydney New South Wales Australia"},{"name":"Royal Prince Alfred Institute of Academic Surgery Sydney Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health Sciences, Sydney Medical School The University of Sydney  Sydney New South Wales Australia"},{"name":"Royal Prince Alfred Institute of Academic Surgery Sydney Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Wykes","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health Sciences, Sydney Medical School The University of Sydney  Sydney New South Wales 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