{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:16:50Z","timestamp":1791595010640,"version":"4.3.4"},"reference-count":95,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Head and neck cancer (HNC) remains a major global health issue. It is closely linked to smoking, alcohol use, and HPV infection. Nutritional and metabolic factors significantly influence surgical outcomes in these patients, especially when undergoing extensive resections and microsurgical free flap reconstruction. This comprehensive review aims to evaluate how perioperative nutritional status\u2014particularly body mass index (BMI), serum albumin and prealbumin levels, and enteral vs. oral feeding strategies\u2014affects complication rates, wound healing, surgical duration, and overall recovery. Poor nutritional status is associated with increased complication rates, prolonged surgery, impaired wound healing, and higher perioperative mortality. Both high and low BMI negatively impact surgical outcomes. Obesity is linked to protracted surgery and increased blood loss, while underweight patients have higher perioperative mortality. Optimizing perioperative nutrition is important for improving surgical outcomes in HNC patients. A multidisciplinary approach is necessary to tailor nutritional support and enhance recovery. Further research should focus on long-term weight management strategies and identifying biomarkers predictive of surgical success.<\/jats:p>","DOI":"10.3390\/jcm14113679","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T12:24:18Z","timestamp":1748003058000},"page":"3679","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Perioperative Nutritional and Metabolic Factors Affecting Surgical Outcomes in Head and Neck Cancer Free Flap Reconstruction: A Comprehensive Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8515-3978","authenticated-orcid":false,"given":"Andrzej","family":"Jaxa-Kwiatkowski","sequence":"first","affiliation":[{"name":"Clinical Department of Maxillofacial Surgery, Faculty of Dentistry, Wroclaw Medical University, 50-367 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Jaxa-Kwiatkowski","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery, Heliodor Swiecicki Clinical Hospital in Poznan, 60-355 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Jaxa-Kwiatkowska","sequence":"additional","affiliation":[{"name":"Division of Anatomy Part of the Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, 50-367 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0954-3955","authenticated-orcid":false,"given":"Hanna","family":"Gerber","sequence":"additional","affiliation":[{"name":"Clinical Department of Maxillofacial Surgery, Faculty of Dentistry, Wroclaw Medical University, 50-367 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4886-3369","authenticated-orcid":false,"given":"Marcin","family":"Kubiak","sequence":"additional","affiliation":[{"name":"Clinical Department of Maxillofacial Surgery, Faculty of Dentistry, Wroclaw Medical University, 50-367 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"\u0141ysenko","sequence":"additional","affiliation":[{"name":"Department and Clinic of Anaesthesiology and Intensive Care, Faculty of Medicine, Wroclaw Medical University, 50-367 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1038\/s41415-022-5166-x","article-title":"Reviewing the Epidemiology of Head and Neck Cancer: Definitions, Trends and Risk Factors","volume":"233","author":"Gormley","year":"2022","journal-title":"Br. 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