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Volume 10 Supplement 1

de Senectute: Age and Health Forum

  • Lecture presentation
  • Open Access

Is there any chance for microsurgical reconstructions in elderly?

  • 1,
  • 2 and
  • 1
BMC Geriatrics201010 (Suppl 1) :L14

https://doi.org/10.1186/1471-2318-10-S1-L14

  • Published:

Keywords

  • Vascular Disease
  • Donor Site
  • Medical Complication
  • Donor Site Morbidity
  • Common Operation
In Italy there is a increase in the percentage of population aged over 70 with a gradual increase in average life expectancy (Table 1).
Table 1

Mean of average life expectancy

Age

Man

Female

70-75

11,8

15

75-80

9,1

11,7

80-85

6,8

8,7

> 80

5,1

6,3

Some studies show that septuagenarians have a greater chance of survival than octogenarians postoperatively and a lower incidence of mortality perioperatively [1].

Recent studies show that elderliness is not an independent risk factor for microsurgical complications, but it is related to increased incidence of medical complications, particularly in patients with more 'comorbidities' and with a higher American Society of Anesthesiologists status [2]. The need of considering some important aspects during the preoperative phase is important in evaluation of an elderly to be subjected to a microsurgical operation.

These factors are: prolonged operation time due to microsurgical anastomosys; donor site morbidity; condition of recipient vessels. In order to satisfy these criteria, some therapeutic devices could be advanced such as perioperative prophylactic anticoagulation [3].

The indications for microvascular free-tissue transfers (MFTT) in the elderly are different from those in the young: post car-traumas are treated in lower extremity, risks to which an elderly is less exposed. Moreover they are not common operations because elderly vessels are more affected by vascular diseases; in trunk, elderly rarely requires reconstruction. MFTT made in head-neck district are the same in percentage as the ones made on the young: if we have a loss of tissue, reconstruction must be immediate in both. Moreover the recipient vessels are less affected by atherosclerosis than peripheral vessels .The percentage of surgical complications is equal in both.

Conclusions

The limit in MFTT on an elderly patient is notimposed by the technique used but by the request of the patient and by the status of his vessels. If a patient’s medical problem doesn’t represent a handicap, MFTT can be safely performed in the elderly by using proper techniques and precautions.

Authors’ Affiliations

(1)
Cattedra di Chirurgia Plastica e Ricostruttiva, Università degli studi Cagliari, Italy
(2)
Dipartimento di Discipline Chirurgiche ed Oncologiche, Sezione Chirurgia Plastica, Università di Palermo, Italy

References

  1. Howard MA, et al: Free Tissue Transfer in the Elderly: Incidenceof Perioperative Complications following Microsurgical Reconstruction of 197 Septuagenarians and Octogenarians. Plastic And Reconstructive Surgery. 2005, 116 (6): 1659-1668. 10.1097/01.prs.0000187135.49423.9f.PubMedView ArticleGoogle Scholar
  2. Perrot P, et al: La reconstruction par lambeau libre chez lesujet age´. Annales de chirurgie plastique esthétique. 2008, 53: 420-423. 10.1016/j.anplas.2007.09.006.View ArticleGoogle Scholar
  3. Chen HC, M.D., et al: Guidelines for the optimization of microsurgery in atherosclerotic patients. Microsurgery. 2006, 26 (5): 356-362. 10.1002/micr.20252.PubMedView ArticleGoogle Scholar

Copyright

© Ribuffo et al; licensee BioMed Central Ltd. 2010

This article is published under license to BioMed Central Ltd.

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