Analysis of Factors Affecting Flap Necrosis in Patients with Skin and Soft Tissue Defects after Free Flap Transplantation

LV Bairong; CAO Jianhua; LUO Lina; YANG Chen

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Journal of Hunan Normal University(Medical Science) ›› 2026, Vol. 23 ›› Issue (1) : 121-125.

Analysis of Factors Affecting Flap Necrosis in Patients with Skin and Soft Tissue Defects after Free Flap Transplantation

LV Bairong¹, CAO Jianhua¹, LUO Lina², YANG Chen¹

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Abstract

Objective To investigate the influencing factors of flap necrosis in patients with skin and soft tissue defects after free flap transplantation. Methods A total of 180 patients with skin and soft tissue defects of limbs who received free skin flap transplantation in Beijing Jishuitan Hospital from March 2021 to December 2023 were enrolled and analyzed. According to postoperative survival of skin flap, they were divided into survival group (n=158) and necrosis group (n=22). The clinical data and laboratory indexes of patients were compared. Single and multiple Logistic regression were used to analyze the influencing factors of flap necrosis in patients with skin and soft tissue defects of limbs after free flap transplantation. Results Univariate analysis showed that there were significant differences in gender, smoking history, vascular crisis, body mass index (BMI) and operation time between the surviving group and the necrotic group (all P<0.05). Multivariate regression analysis showed that smoking history, vascular crisis and high BMI were independent risk factors for flap necrosis in patients with skin and soft tissue defects of limbs after free flap transplantation (all P<0.05). The area under the curve (AUC) of the combined prediction was 0.773(95%CI 0.671~0.875). The calibration curve shows that there is a good agreement between the predicted value and the actual value, and the average absolute error is 0.033. Hosmer-Lemeshow goodness of fit test showed that the prediction model had a good calibration degree (χ²=794, P=0.531). Conclusion The necrosis of skin flap after free skin flap transplantation in patients with soft tissue defect of extremities may be related to smoking history, vascular crisis, high BMI.

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influencing factors / skin soft tissue defect / flap necrosis / free flap grafting

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LV Bairong, CAO Jianhua, LUO Lina, YANG Chen. Analysis of Factors Affecting Flap Necrosis in Patients with Skin and Soft Tissue Defects after Free Flap Transplantation[J]. Journal of Hunan Normal University(Medical Science). 2026, 23(1): 121-125

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