The Effects of Type 2 Diabetes Mellitus on the Success of Free Tissue Transfer

Öz

Aim: Free tissue transfer is still gold standard in wide tissue defect treatments. Free tissue transfers whose success depends on vascular anastomosis will be affected by every situation which affects vessels. Diabetes mellitus is a worldwide well known vasculopatic disorder . Although, it has serious deteriorative effects on all vascular anatomy and physiology, the effects of diabetes mellitus on the success of free tissue transfer surgery hasn’t been well studied yet. In this study, we aimed to investigate the effects of diabetes mellitus on the success and complications of free tissue transfer surgery.

Material and Methods: 107 adult patients who undertook free tissue transfer surgery in Plastic, Reconstructive and Aesthetic Surgery Department of Atatürk University Medical Faculty between January 2010 and January 2019 were included in this study. Patients were divided into two groups as Group 1 (18 patients with Diabetes Mellitus) and Group 2 (89 patients without diabetes mellitus). The groups were compared for surgical complications and success.

Results: Arterial thrombosis was found as 22.2% in group 1 and 5.6% in Group 2 (p=0.021). Diabetic patients needed more revisional surgery than non-diabetic cases (p=0.030). Surgeries failed in 33.3% of cases in Group 1 and 13.5% of patients in Group 2 (p=0.040). The frequency of intra-postoperative anastomosis problems and heamatomas were higher in diabetics than non-diabetics, but the difference was not statistically significant.

Conclusion: In free tissue transfer surgery, we found more complications and low-success rate in diabetic cases than non-diabetics. Diabetic cases need more attention and close follow-up period after free tissue transfer surgery.

Anahtar Kelimeler

• Diabetes mellitus
• Free tissue transfer
• Free flap

Tip 2 Diabetes Mellitusun Serbest Doku Nakli Başarısına Etkisi

Öz

Amaç: Geniş doku defektlerinde serbest doku nakli hâlâ altın standarttır. Başarısı damar anastomozuna bağlı olan serbest doku nakli,damarı etkileyen her durumdan etkilenecektir. Bunların başında da Tip 2 Diabetes Mellitus gelmektedir. Bununla birlikte serbest doku nakli işlemlerinde diyabetin başarıya etkisi hâlâ yeteri kadar incelenmemiştir. Bu nedenle, bu çalışmada serbest doku nakli yapılan, diyabetik ve non-diyabetik hasta gruplarını, komplikasyon ve başarı oranları açısından karşılaştırmayı amaçladık.

Gereç ve Yöntemler: Atatürk Üniversitesi, Tıp Fakültesi, Plastik, Rekonstrüktif ve Estetik Cerrahi Kliniği’nde Ocak 2010 - Ocak 2019 arasında, serbest doku nakli yapılan, 40 yaş üstü 107 hasta çalışmaya dahil edildi. Tip 2 Diabetes Mellitus tanısı olan 18 (Grup 1) ve diyabeti olmayan 89 (Grup 2) olgu, komplikasyon oranları ve ameliyat başarısı açısından karşılaştırıldı.

Bulgular: Grup 1’de %22,2, Grup 2’de %5,6 oranında arteriyel trombüs gelişti (p=0,021). Grup 1’deki hastalara istatistiksel olarak anlamlı derecede daha fazla revizyon ameliyatı gerekti (p=0,030). Grup 1’de %33,3, Grup 2’de ise %13,5 oranında nakledilen doku başarısızlıkla sonuçlandı (p=0,040). İstatistiksel olarak anlamlı bulunmasa da Grup 1’deki hasta grubunda daha sık intra-postoperatif anastomoz problemi ve hematom komplikasyonu görüldü.

Sonuç: Serbest doku nakli yapılacak diyabetik hastalarda, daha fazla komplikasyon görülür ve başarı oranı daha düşüktür. Bu nedenle ameliyat öncesi ayrıntılı değerlendirme ve ameliyat sonrası sıkı takip gerektirmektedir.

Anahtar Kelimeler

• Diabetes mellitus
• Serbest doku nakli
• Serbest flep

Kaynakça

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